{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T07:41:18Z","timestamp":1784619678920,"version":"3.55.0"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,5,1]]},"abstract":"<jats:p>Cardiotoxicity is a rare but challenging complication of 5-fluorouracil (5-FU) therapy. Compared with 5-FU, after application of S-1 lower plasma levels of the cardiotoxic metabolite alpha-fluoro-beta-alanine have been reported. Evidence for safe administration of S-1 following 5-FU cardiotoxicity is limited to a case report in an Asian patient. Herein we report the first case of S-1 application after 5-FU cardiotoxicity in a Caucasian patient.<\/jats:p>\n               <jats:p>A 67-year-old man with right-sided metastatic colorectal cancer and history of 5-FU cardiotoxicity had a progressive disease after 8-month therapy with irinotecan and bevacizumab. In consideration of known 5-FU cardiotoxicity, he was referred to our department for therapy counselling. We started a combination therapy with S-1, oxaliplatin and bevacizumab. The treatment was well tolerated without any cardiac problems.<\/jats:p>\n               <jats:p>Our report confirms the safety of S-1 in cases of 5-FU cardiotoxicity also in a Caucasian patient.<\/jats:p>","DOI":"10.1136\/bcr-2016-219162","type":"journal-article","created":{"date-parts":[[2017,5,22]],"date-time":"2017-05-22T23:45:29Z","timestamp":1495496729000},"page":"bcr-2016-219162","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Safe administration of S-1 after 5-fluorouracil-induced cardiotoxicity in a patient with colorectal cancer"],"prefix":"10.1136","volume":"2017","author":[{"given":"Caspar","family":"Franck","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Malfertheiner","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marino","family":"Venerito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,5,22]]},"reference":[{"key":"2025082723113021000_2017.may17_1.bcr-2016-219162.1","doi-asserted-by":"publisher","DOI":"10.5603\/CJ.2012.0084"},{"key":"2025082723113021000_2017.may17_1.bcr-2016-219162.2","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s10147-005-0516-7","article-title":"5-Fluorouracil cardiotoxicity induced by alpha-fluoro-beta-alanine","volume":"10","author":"Muneoka","year":"2005","journal-title":"Int J Clin Oncol"},{"key":"2025082723113021000_2017.may17_1.bcr-2016-219162.3","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1186\/s12885-016-2409-8","article-title":"TAS-102, the first \"cardio-gentle\" fluoropyrimidine in the colorectal cancer landscape?","volume":"16","author":"Petrelli","year":"2016","journal-title":"BMC Cancer"},{"key":"2025082723113021000_2017.may17_1.bcr-2016-219162.4","doi-asserted-by":"crossref","first-page":"881","DOI":"10.3109\/0284186X.2016.1161825","article-title":"Experience with S-1 in older Caucasian patients with metastatic colorectal cancer (mCRC): Findings from an observational chart review","volume":"55","author":"Winther","year":"2016","journal-title":"Acta Oncol"},{"key":"2025082723113021000_2017.may17_1.bcr-2016-219162.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.clcc.2012.09.003"},{"key":"2025082723113021000_2017.may17_1.bcr-2016-219162.6","first-page":"89","article-title":"Dihydropyrimidine dehydrogenase gene (DPYD) polymorphism among Caucasian and non-Caucasian patients with 5-FU- and capecitabine-related toxicity using full sequencing of DPYD","volume":"10","author":"Saif","year":"2013","journal-title":"Cancer Genomics Proteomics"},{"key":"2025082723113021000_2017.may17_1.bcr-2016-219162.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200009283431302"},{"key":"2025082723113021000_2017.may17_1.bcr-2016-219162.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1349-7006.2010.01793.x"},{"key":"2025082723113021000_2017.may17_1.bcr-2016-219162.9","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.7150\/jca.12819","article-title":"A Muti-center, randomized phase II study of oxaliplatin and S-1 versus capecitabine and oxaliplatin in patients with metastatic colorectal cancer","volume":"6","author":"Kim","year":"2015","journal-title":"J Cancer"},{"key":"2025082723113021000_2017.may17_1.bcr-2016-219162.10","unstructured":"Dutch Colorectal Cancer Group. S-1 Versus Capecitabine in the First Line treatment of MCC patients (SALTO). ClinicalTrials.gov 2016. https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01918852 ."},{"key":"2025082723113021000_2017.may17_1.bcr-2016-219162.11","first-page":"4605","article-title":"Efficacy of Combination Chemotherapy using a novel oral chemotherapeutic Agent, TAS-102, with oxaliplatin on human colorectal and gastric Cancer xenografts","volume":"35","author":"Nukatsuka","year":"2015","journal-title":"Anticancer Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-219162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:11:38Z","timestamp":1756361498000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-219162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,22]]},"references-count":11,"alternative-id":["10.1136\/bcr-2016-219162"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-219162","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,22]]}}}