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Sorafenib in a patient with advanced hepatocellular carcinoma and serious impairment of left ventricular function: a case report

INTRODUCTION: sorafenib, a tyrosine-kinase inhibitor, is widely used in the treatment of advanced hepatocellular carcinoma. Drug-related toxicities are generally mild but sorafenib, as other similar agents, may induce elevation of systemic arterial blood pressure levels in relation to an interaction...

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Autores principales: Valsuani, Chiara, Siclari, Olimpia, Camerini, Andrea, Canale, Maria Laura, Rondini, Marianna, Donati, Sara, Puccinelli, Paolo, Tartarelli, Gianna, Puccetti, Cheti, Amoroso, Domenico
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803930/
https://www.ncbi.nlm.nih.gov/pubmed/20062650
http://dx.doi.org/10.1186/1757-1626-2-9133
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author Valsuani, Chiara
Siclari, Olimpia
Camerini, Andrea
Canale, Maria Laura
Rondini, Marianna
Donati, Sara
Puccinelli, Paolo
Tartarelli, Gianna
Puccetti, Cheti
Amoroso, Domenico
author_facet Valsuani, Chiara
Siclari, Olimpia
Camerini, Andrea
Canale, Maria Laura
Rondini, Marianna
Donati, Sara
Puccinelli, Paolo
Tartarelli, Gianna
Puccetti, Cheti
Amoroso, Domenico
author_sort Valsuani, Chiara
collection PubMed
description INTRODUCTION: sorafenib, a tyrosine-kinase inhibitor, is widely used in the treatment of advanced hepatocellular carcinoma. Drug-related toxicities are generally mild but sorafenib, as other similar agents, may induce elevation of systemic arterial blood pressure levels in relation to an interaction with cardiovascular system probably mediated by HIF pathway. This side effect may be particularly critical for patients with underlying serious heart disease as it can induce acute heart failure, a life-threatening condition, and usually such patients are excluded from active treatment with tyrosine-kinase inhibitors. We report the case of a patient affected by advanced hepatocellular carcinoma and serious impairment of cardiac function treated with sorafenib without any worsening of heart function. To our knowledge this is the first report of this kind in the literature. CASE PRESENTATION: We report the case of a 74-year-old patient affected by advanced multifocal HCV-cirrhosis related hepatocellular carcinoma and severe post-ischemic fall of left-ventricular function with serious risk of cardiac functional impairment. The patient presented with an ECOG performance status of 0. Blood chemistry tests showed a substantial elevation of α-fetoprotein values and slight increases of bilirubin, of γ-GT and of GOT; the absence of encephalopathy and ascites and the normality of coagulation parameters and of albumin led to classify the patient into the functional class Child-Pugh A. The patients was successfully treated with sorafenib at the reduced daily dose of 400 mg for long-time without any worsening of heart function. CONCLUSION: The presented case can offer to oncologists a clinical support to take into consideration when deciding to treat with sorafenib advanced hepatocellular carcinoma patients presenting with serious impairment of cardiac function that are usually excluded from an active treatment.
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spelling pubmed-28039302010-01-10 Sorafenib in a patient with advanced hepatocellular carcinoma and serious impairment of left ventricular function: a case report Valsuani, Chiara Siclari, Olimpia Camerini, Andrea Canale, Maria Laura Rondini, Marianna Donati, Sara Puccinelli, Paolo Tartarelli, Gianna Puccetti, Cheti Amoroso, Domenico Cases J Case Report INTRODUCTION: sorafenib, a tyrosine-kinase inhibitor, is widely used in the treatment of advanced hepatocellular carcinoma. Drug-related toxicities are generally mild but sorafenib, as other similar agents, may induce elevation of systemic arterial blood pressure levels in relation to an interaction with cardiovascular system probably mediated by HIF pathway. This side effect may be particularly critical for patients with underlying serious heart disease as it can induce acute heart failure, a life-threatening condition, and usually such patients are excluded from active treatment with tyrosine-kinase inhibitors. We report the case of a patient affected by advanced hepatocellular carcinoma and serious impairment of cardiac function treated with sorafenib without any worsening of heart function. To our knowledge this is the first report of this kind in the literature. CASE PRESENTATION: We report the case of a 74-year-old patient affected by advanced multifocal HCV-cirrhosis related hepatocellular carcinoma and severe post-ischemic fall of left-ventricular function with serious risk of cardiac functional impairment. The patient presented with an ECOG performance status of 0. Blood chemistry tests showed a substantial elevation of α-fetoprotein values and slight increases of bilirubin, of γ-GT and of GOT; the absence of encephalopathy and ascites and the normality of coagulation parameters and of albumin led to classify the patient into the functional class Child-Pugh A. The patients was successfully treated with sorafenib at the reduced daily dose of 400 mg for long-time without any worsening of heart function. CONCLUSION: The presented case can offer to oncologists a clinical support to take into consideration when deciding to treat with sorafenib advanced hepatocellular carcinoma patients presenting with serious impairment of cardiac function that are usually excluded from an active treatment. BioMed Central 2009-12-02 /pmc/articles/PMC2803930/ /pubmed/20062650 http://dx.doi.org/10.1186/1757-1626-2-9133 Text en Copyright ©2009 Valsuani et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Valsuani, Chiara
Siclari, Olimpia
Camerini, Andrea
Canale, Maria Laura
Rondini, Marianna
Donati, Sara
Puccinelli, Paolo
Tartarelli, Gianna
Puccetti, Cheti
Amoroso, Domenico
Sorafenib in a patient with advanced hepatocellular carcinoma and serious impairment of left ventricular function: a case report
title Sorafenib in a patient with advanced hepatocellular carcinoma and serious impairment of left ventricular function: a case report
title_full Sorafenib in a patient with advanced hepatocellular carcinoma and serious impairment of left ventricular function: a case report
title_fullStr Sorafenib in a patient with advanced hepatocellular carcinoma and serious impairment of left ventricular function: a case report
title_full_unstemmed Sorafenib in a patient with advanced hepatocellular carcinoma and serious impairment of left ventricular function: a case report
title_short Sorafenib in a patient with advanced hepatocellular carcinoma and serious impairment of left ventricular function: a case report
title_sort sorafenib in a patient with advanced hepatocellular carcinoma and serious impairment of left ventricular function: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803930/
https://www.ncbi.nlm.nih.gov/pubmed/20062650
http://dx.doi.org/10.1186/1757-1626-2-9133
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