One case report and literature review of severe cardiotoxicity by oxaliplatin combined with capecitabine
- VernacularTitle:1例奥沙利铂联合卡培他滨致严重心脏毒性病例报道及文献复习
- Author:
Lina XU
1
,
2
;
Yingli FANG
1
;
Xiangling WANG
3
;
Pengcheng DU
2
Author Information
1. Dept. of Clinical Pharmacy，Qilu Hospital of Shandong University，Jinan 250012，China
2. Dept. of Clinical Pharmacy，Dezhou Hospital，Qilu Hospital of Shandong University，Shandong Dezhou 253000，China
3. Dept. of Oncology，Qilu Hospital of Shandong University，Jinan 250012，China
- Publication Type:Journal Article
- Keywords:
oxaliplatin;
capecitabine;
cardiotoxicity;
severe adverse reaction;
pharmaceutical care;
clinical pharmacist
- From:
China Pharmacy
2025;36(10):1248-1253
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the relationship between severe cardiotoxicity caused by oxaliplatin combined with capecitabine and genetic polymorphism， thereby providing references for safe clinical medication use. METHODS Clinical pharmacists conducted a correlation analysis on a case of severe cardiotoxicity in a rectal cancer patient at Qilu Hospital of Shandong University following first-time treatment with standard doses of oxaliplatin combined with capecitabine. Case reports of cardiotoxicity caused by oxaliplatin and capecitabine were retrieved from the Chinese and English databases such as CNKI and PubMed.Basic patient information， drug treatment plan， and cardiotoxic manifestations were extracted and summarized. Combined with the patient’s genetic polymorphism test results related to the metabolism and excretion of platinum-based and fluorouracil drugs， potential mechanisms and prevention strategies for cardiotoxicity induced by oxaliplatin and capecitabine were discussed. RESULTS The patient exhibited homozygous mutations in ABCB1 C3435T and G2677T/A， a heterozygous mutation in MTHFR A1298C， and a heterozygous mutation in GSTP1 A105G， indicating impaired metabolism and excretion of oxaliplatin and capecitabine. The pharmacists recommended discontinuing oxaliplatin and reducing capecitabine to 50% of the original dose for subsequent treatment. The physicians adopted this advice， and the patient experienced no further severe adverse reactions with stable disease progression. CONCLUSIONS Oxaliplatin and capecitabine may cause severe cardiotoxicity. Medical institutions with adequate resources should perform genetic polymorphism test related to drug metabolism and excretion in patients prescribed these agents. For patients with multiple gene mutations， close monitoring and appropriate dose reductions are recommended to ensure medication safety and efficacy.
