Printer Friendly

First case report of Xeloda induced coronary artery disease.

Xeloda (capecitabine) is a fluropyrimidine carbamate with antineoplastic activity, used for the treatment of metastatic colorectal cancer and metastatic breast cancer, two of the most commonly diagnosed forms of cancer among Americans. Xeloda, an oral cancer therapy was initially approved for breast cancer on April 30, 1998. Xeloda is indicated as first-line treatment of patients with metastatic colorectal carcinoma when treatment with fluropyrimidine therapy alone is preferred. Combination chemotherapy with docetaxel has shown a survival benefit compared to 5-FU/LV alone. Xeloda in combination with docetaxel is indicated for the treatment of patients with metastatic breast cancer after failure of prior anthracycline-containing chemotherapy. In Xeloda monotherapy for metastatic colorectal cancer, the most common adverse events were anemia (80%), diarrhea (55%), hand-foot syndrome (54%), hyperbilirubinemia (48%), nausea (43%), fatigue/weakness (42%), abdominal pain (35%), dermatitis (27%), vomiting (27%), appetite decreased (26%), stomatitis (25%), pyrexia (18%), edema (15%), constipation (14%), dyspnea (14%), neutropenia (13%), pain (12%), back pain (10%), and headache (10%). We present the first case report of coronary artery disease induced by Xeloda in a 66-year-old male treated for relapsing metastatic colon cancer. The patient developed typical anginal type chest pain 5 days into the treatment. Adenosine cardiolyte stress test revealed severe ischemia with markedly diminished left ventricular global function, ejection fraction of 30%. The patient had normal exercise stress test with Duke Treadmill score of +6, 2 months prior to initiation of Xeloda, performed for evaluation of atypical chest pain. Xeloda was originally approved under the accelerated approval program that allows early marketing of products for serious or life-threatening illnesses based on "surrogate endpoints." Today's approval is based on actual patient benefit as shown in the clinical trial. Cardiovascular side effects are uncommon and should be considered while patients are treated with Xeloda.

Anil K. Goli, MD, Madhav Koduri, MD, Jack Whitaker, MD, Ann Jackson, MD, and Stephen A. Fahrig MD, Johnson City, TN.
COPYRIGHT 2004 Southern Medical Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2004, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:Section on Oncology
Author:Fahrig, Stephen A.
Publication:Southern Medical Journal
Date:Oct 1, 2004
Words:315
Previous Article:Skin metastasis in a previously irradiated field from squamous cell carcinoma of the cervix.
Next Article:Assessment of four midcarpal radiologic determinations.
Topics:


Related Articles
The heart of depression.
War against the heart.
Early glimmerings of heart disease.
A heartening finding for women on aspirin.
Herpes and heart disease: could viruses encourage coronary clogging?
Folic acid fights heart risk factor.
Unappreciable myocardial bridge causing anterior myocardial infarction and postinfarction angina. (Case Report).
CAR-11. Syndrome X: a bit of a mystery.
Percutaneous intervention of left main coronary artery disease: a fresh look at a class III recommendation.

Terms of use | Copyright © 2017 Farlex, Inc. | Feedback | For webmasters