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Use of paclitaxel in patients with pre‐existing cardiomyopathy: A review of our experience
Author(s) -
Gollerkeri Ashwin,
Harrold Laurie,
Rose Michal,
Jain Diwaker,
Burtness Barbara Ann
Publication year - 2001
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.1295
Subject(s) - medicine , ejection fraction , paclitaxel , discontinuation , heart failure , cardiomyopathy , anthracycline , cardiology , outpatient clinic , cardiac function curve , chemotherapy , surgery , oncology , cancer , breast cancer
Cardiac toxicity is frequently the indication for discontinuation of an anthracycline in patients with tumors which remain anthracycline‐sensitive. During the 1990s, the most frequently used second‐line agents at the Yale Cancer Center (YCC) were the taxanes. The goal of this retrospective analysis was to determine the effect of paclitaxel on cardiac function in patients with cardiomyopathy. YCC outpatient clinic pharmacy order forms were used to identify all patients who had received paclitaxel between December 1995 and November 1997. The clinic records of those patients with a left ventricular ejection fraction (LVEF) of ≤50% were reviewed to determine the temporal relation between the decreased LVEF and paclitaxel therapy. In addition, clinic records were examined for evidence of prior doxorubicin therapy and history of prior cardiac disease. Between December 1995 and November 1997, 225 patients were treated with paclitaxel in the YCC outpatient clinic. Nine patients had LVEF ≤50% (mean 37%) prior to initiation of paclitaxel therapy. Six of these patients had equilibrium radionuclide angiocardiographic (ERNA) scans following completion of paclitaxel. In these 6 patients, the mean change in LVEF was +6% (range –3% to +29%). Four patients had improved LVEF following paclitaxel (mean 11%, range 2% to 29%), while 2 patients experienced a decrease in LVEF following paclitaxel treatment (mean 2.5%). The 3 patients who did not have ERNA scans following paclitaxel therapy had no clinical evidence of congestive heart failure. Our experience confirms the results of prior studies that paclitaxel can be safely administered in patients with underlying cardiac dysfunction. © 2001 Wiley‐Liss, Inc.