{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T23:42:48Z","timestamp":1776642168969,"version":"3.51.2"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006451","name":"Hospices Civils de Lyon","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006451","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Fluoropyrimidines, including 5-fluorouracil (5-FU) and capecitabine, remain foundational in the treatment of various cancers, despite their well-documented risk of cardiotoxicity. This study aimed to characterize cardiovascular events associated with fluoropyrimidine use, evaluate their management, and assess the prognostic impact of fluoropyrimidine reintroduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of patients admitted for cardiovascular events between January 2014 and October 2024 at Croix-Rousse and Lyon Sud University Hospitals (Hospices Civils de Lyon, France), who had received fluoropyrimidine-based chemotherapy within the preceding year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 141 patients, the most frequent cardiovascular events were coronary artery disease (30.5%), atrial fibrillation (28.4%), and heart failure (19.9%). Post-event, three primary therapeutic strategies were implemented in the follow-up cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009114): fluoropyrimidine reintroduction (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200954, 38.3%), switch to alternative chemotherapy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925, 17.7%), and transition to palliative care (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200936, 25.5%). Recurrent cardiotoxicity after reintroduction occurred in eight patients (14.8%), with only one recurrent coronary event. At 2-year follow-up, overall survival tended to be higher in the reintroduction group compared to the group of patients switching to an alternative chemotherapy (HR\u2009=\u20091.77 [0.92\u20133.42];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.088) and to palliative care (HR\u2009=\u20098.31 [4.67\u201314.79];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No significant increase in unplanned hospitalizations was observed in the reintroduction group compared to the alternative chemotherapy group (HR\u2009=\u20091.48 [0.83\u20132.66];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.185).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that fluoropyrimidine reintroduction\u2014guided by multidisciplinary evaluation, cardiovascular management, and close monitoring\u2014appears to have a favorable benefit\/risk balance for selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-026-10531-2","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T01:23:57Z","timestamp":1772933037000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Fluoropyrimidine-induced cardiotoxicity: outcomes and safety of chemotherapy reintroduction in a retrospective cohort study"],"prefix":"10.1007","volume":"34","author":[{"given":"Oc\u00e9ane","family":"R\u00e9a","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anissa","family":"Bouali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micha\u00ebl","family":"Serraille","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"P\u00e9ron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Falandry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justine","family":"Fort","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Fran\u00e7ois","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brahim","family":"Harbaoui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Lantelme","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre-Yves","family":"Courand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,8]]},"reference":[{"issue":"10","key":"10531_CR1","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1016\/j.annonc.2022.07.004","volume":"33","author":"F Lordick","year":"2022","unstructured":"Lordick F, Carneiro F, Cascinu S et al (2022) Gastric cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. 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