CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Curr Cardiol Rep. 2021 Feb 3;23(3):17. doi: 10.1007/s11886-021-01441-2.
5-fluorouracil (5-FU) is one of the most common causes of cardiotoxicity associated with chemotherapy. The manifestations of 5-FU cardiotoxicity are diverse, and there are no established clinical guidelines addressing the diagnosis and management of this condition. Here we summarize the mechanistic and clinical data available to guide clinicians in caring for patients with suspected 5-FU cardiotoxicity.
The decision to resume 5-FU treatment in patients with suspected cardiovascular toxicity remains challenging. Testing for predisposing genetic variants may be helpful, particularly in patients with other signs of 5-FU toxicity. Uridine triacetate is a recently approved antidote that can improve clinical outcomes in patients with life-threatening fluoropyrimidine cardiotoxicity. 5-FU cardiotoxicity remains poorly understood, with limited mechanistic or prospective clinical trial data available to define risk factors or effective management strategies. Risk stratification and therapeutic decisions should be individualized, based on the risk-benefit ratio of continuing 5-FU therapy for each patient.
5-氟尿嘧啶（5-FU）是与化疗相关的最常见的引起心脏毒性的药物之一。5-FU 心脏毒性的表现多种多样，目前尚无关于该疾病诊断和管理的既定临床指南。在这里，我们总结了现有的机制和临床数据，以指导临床医生对疑似 5-FU 心脏毒性的患者进行治疗。
对于疑似心血管毒性的患者，决定是否恢复 5-FU 治疗仍然具有挑战性。检测易患遗传变异可能会有所帮助，特别是在有其他 5-FU 毒性迹象的患者中。三乙酸尿苷是一种最近批准的解毒剂，可改善有生命威胁的氟嘧啶心脏毒性患者的临床结局。5-FU 心脏毒性仍知之甚少，可用的机制或前瞻性临床试验数据有限，无法确定危险因素或有效的管理策略。风险分层和治疗决策应个体化，基于每位患者继续 5-FU 治疗的风险-获益比。
