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Cardiotoxicity: consider switching to S-1

A retrospective cohort study of patients presenting with cardiotoxicity after treatment with fluoropyrimidines suggests that switching to S-1 (i.e. a combination of tegafur, gimeracil, and oteracil, at a molar ratio of 1:0.4:1) is safe for these patients and supports treatment continuation.

Fluoropyrimidines (e.g. capecitabine, 5-fluorouracil) are widely used to treat solid tumours but are linked to clinical cardiotoxicity in about 5% of patients, often leading to discontinuation. In addition, subclinical cardiotoxicity may be much more common; present in up to one third of patients. Cardiotoxicity may be less frequent in patients treated with S-1 as compared with 5-fluorouracil and capecitabine, but head-to-head comparisons are lacking.

Prof. Pia Österlund (Tampere University Hospital, Finland) presented a 6-country, 12-centre retrospective cohort study including patients with solid tumours (ICD10 C15-C2...

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