Gemcitabine-induced dilated-cardiomyopathy in patient with platinum-refractory ovarian-cancer: A case report and literature review. (August 2021)

• Record Type: Journal Article
• Authors: Raimondi, Lucrezia; Raimondi, Filippo Maria; Rossi, Luigi; Lazzeroni, Rachele; Pietranera, Marta; Di Benedetto, Laura; Gozzi, Elisa; Spinelli, Gian Paolo
• Is Part Of: Journal of oncology pharmacy practice. Volume 27:Number 6(2021)
• Page Start: 1542
• Page End: 1547
• Publication Date: 2021-08
• Subjects: Gemcitabine -- dilated cardiomyopathy -- cardiotoxicity -- ovarian cancer -- platinum-resistant; Cancer -- Chemotherapy -- Periodicals; Clinical pharmacology -- Periodicals; 616.994061
• DOI: 10.1177/1078155220982044
• Languages: English
• ISSNs: 1078-1552

Abstract

Introduction: Gemcitabine is a nucleoside analog and pyrimidine antimetabolite that inhibits RNA synthesis, currently approved for use to treat a variety of cancers, among which ovarian cancers. Gemcitabine is considered relatively safe and it is generally well tolerated, with rarely reported cardiac side effects. Case report: We report a case of gemcitabine induced dilated cardiomyopathy in a 41-year-old woman receiving gemcitabine as second line treatment for platinum-resistant ovarian cancer without pre-existing hypertension or significant cardiac history. Management and Outcome: The patient presented with clinical symptoms and laboratory and imaging results suggestive of congestive cardiac failure, with a left ventricular ejection fraction of 15%. Gemcitabine administration was stopped and Furosemide with ACE-inhibitors and Beta-blocker agents were initiated. At that point the clinical situation improved: symptoms and findings disappeared with gemcitabine cessation. Discussion: Our case demonstrated for the first time objective evidence for dilated cardiomyopathy induced by gemcitabine in a young patient with platinum-resistant ovarian cancer without pre-existing significant cardiac history. Although rare, gemcitabine-induced cardiotoxicity should be promptly recognized in order to take appropriate measures to manage it.