Sudden cardiac death in a patient with advanced hepatocellular carcinoma with good response to sorafenib treatment: A case report with literature analysis

Calistri, Linda; Cordopatri, Cesare; Nardi, Cosimo; Gianni, Elena; Marra, Fabio; Colagrande, Stefano

doi:10.3892/mco.2017.1132

Cited by 6 publications

(4 citation statements)

References 52 publications

(45 reference statements)

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“…However, some TKIs have been reported to cause a significant prolongation of the electrocardiographic QTc interval when used to treat patients with advanced carcinoma [4]. Various agents and conditions that cause 2 of 13 prolongation of the QTc interval may predispose an individual to tosade de pointes tachyarrhythmia, which may result in syncope or sudden death [5,6]. However, the ionic mechanisms of TKI actions on heart cells are incompletely understood.…”

Section: Introductionmentioning

confidence: 99%

Differential Inhibitory Actions of Multitargeted Tyrosine Kinase Inhibitors on Different Ionic Current Types in Cardiomyocytes

Chang

Liu

Lee

et al. 2020

IJMS

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Lapatinib (LAP) and sorafenib (SOR) are multitargeted tyrosine kinase inhibitors (TKIs) with antineoplastic properties. In clinical observations, LAP and SOR may contribute to QTc prolongation, but the detailed mechanism for this has been largely unexplored. In this study, we investigated whether LAP and SOR affect the activities of membrane ion channels. Using a small animal model and primary cardiomyocytes, we studied the impact of LAP and SOR on Na + and K + currents. We found that LAP-induced QTc prolongation in mice was reversed by isoproterenol. LAP or SOR suppressed the amplitude of the slowly activating delayed-rectifier K + current (I K(S) ) in H9c2 cells in a time-and concentration-dependent fashion. The LAP-mediated inhibition of I K(S) was reversed by adding isoproterenol or meclofenamic acid, but not by adding diazoxide. The steady-state activation curve of I K(S) during exposure to LAP or SOR was shifted toward a less negative potential, with no change in the gating charge required to activate the current. LAP shortened the recovery from I K(S) deactivation. As rapid repetitive stimuli, the I K(S) amplitude decreased; however; the LAP-induced inhibition of I K(S) remained effective. LAP or SOR alone also suppressed inwardly rectifying K + and voltage-gated Na + current in neonatal rat ventricular myocytes. The inhibition of ionic currents during exposure to TKIs could be an important mechanism underlying changes in QTc intervals.

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Section: Introductionmentioning

confidence: 99%

Differential Inhibitory Actions of Multitargeted Tyrosine Kinase Inhibitors on Different Ionic Current Types in Cardiomyocytes

Chang

Liu

Lee

et al. 2020

IJMS

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“…They reduced the dose to 400 mg per day until the unset of the sudden cardiac attack. This attack happened after 8 months of treatment and led to the death of the patient within 10 minutes [7].…”

Section: Discussionmentioning

confidence: 99%

“…Cardiovascular events are possible, but not frequent. They include arterial hypertension, congestive heart failure, cardiomyopathy, acute myocardial infarction, and cardiogenic stroke [5] [6] [7] [8] [9]. These side effects are underestimated, but can lead to the death of the patient before the cancer disease.…”

Section: Introductionmentioning

confidence: 99%

Acute Coronary Syndrome Occurring in a Sub-Saharan Patient Treated with a Reduced Dose of Sorafenib for an Unresectable Hepatocellular Carcinoma: Case Report

Ndam¹,

Helles²,

Kowo³

et al. 2020

OJGas

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Sorafenib is a chemotherapy used as first line treatment in primary liver cancers. It is an oral antiangiogenic treatment which reduces the progression of the tumor. Some mild or severe side effects have been reported among which some uncommon cardiac events: myocardial infarction and cardiogenic stroke. Sorafenib treatment remains expensive and not frequently used in Sub-Saharan countries. Thus, few studies have described its side effects in this milieu. We report a case of acute coronary syndrome occurring in a 75-year-old female patient, without cardiovascular risks factors, after nine months of sorafenib chemotherapy at a reduced dose for an unresectable hepatocellular carcinoma in a Sub-Saharan Africa country. The management was conducted by cardiologists, in collaboration with gastroenterologists and oncologists. We decided to completely stop sorafenib chemotherapy. We observed a reduction of the pain 48 hours after her admission, and a regression of electrocardiographic signs after 8 days. In conclusion, the sorafenib treatment can be associated with cardiac events despite the dose reduction.

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“… 66-70 The type of cardiovascular event for these anti-cancer treatments ranged from asymptomatic reduction in LVEF to sudden cardiac death. 71 , 72 Doxorubicin and trastuzumab exhibit their cardiotoxic effects via different pathways, hence they synergistically increase the risk of cardiovascular events when given concurrently. Doxorubicin is responsible for permanent cardiac muscle death, whereas trastuzumab promotes reversible cardiomyocyte dysfunction.…”

Section: Cardiotoxicity Of Several Anti-cancer Drugsmentioning

confidence: 99%

Management of COVID-19 in cancer patients receiving cardiotoxic anti-cancer therapy. Future recommendations for cardio-oncology

Kobat¹,

Elkonaissi²,

Dorak³

et al. 2021

Oncol Rev

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Cardiotoxicity induced by anti-cancer treatment has become a significant threat as the number of cardiotoxic anti-cancer agents is growing. Cancer patients are at an increased risk of contracting coronavirus disease 2019 (COVID-19) because of immune suppression caused by anti-cancer drugs and/or supportive treatment. Deterioration in lung functions due to COVID-19 is responsible for many cardiac events. The presence of COVID-19 and some of its treatment modalities may increase the chance of cardiotoxicity development in cancer patients receiving potentially cardiotoxic agents. This review provides evidence-based information on the cardiotoxicity risk in cancer patients clinically diagnosed with COVID-19 who are receiving potentially cardiotoxic anti-cancer agents. Proposed strategies relating to the management of this patient cohorts are also discussed.

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Sudden cardiac death in a patient with advanced hepatocellular carcinoma with good response to sorafenib treatment: A case report with literature analysis

Cited by 6 publications

References 52 publications

Differential Inhibitory Actions of Multitargeted Tyrosine Kinase Inhibitors on Different Ionic Current Types in Cardiomyocytes

Differential Inhibitory Actions of Multitargeted Tyrosine Kinase Inhibitors on Different Ionic Current Types in Cardiomyocytes

Acute Coronary Syndrome Occurring in a Sub-Saharan Patient Treated with a Reduced Dose of Sorafenib for an Unresectable Hepatocellular Carcinoma: Case Report

Management of COVID-19 in cancer patients receiving cardiotoxic anti-cancer therapy. Future recommendations for cardio-oncology

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