Reactions 734 - 16 Jan 1999

Safety of paclitaxel acceptable inpatients with cardiac risk factorsPaclitaxel has an ‘acceptable toxicity profile’ in

patients with major pre-existing cardiac risk factors whoreceive the agent for gynaecological cancer, according tothe results of a study by Dr Maurie Markam andcolleagues from the US.1

In the study, the researchers identified 15 patientswith significant cardiac risk factors who received eitherpaclitaxel alone or paclitaxel with cisplatin or carboplatinfor gynaecological cancers. None of these 15 patientsexperienced a deterioration in cardiac function followingpaclitaxel therapy. One patient developed a severehypersensitivity reaction with dyspnoea, tachycardiaand hypotension, without any deterioration of her pre-existing cardiovascular status.

The researchers point out that they cannot commentabout the safety of paclitaxel in combination with otheragents apart from carboplatin or cisplatin. Also, as onlyone patient in their study had a severe cardiacconduction defect, they cannot be certain of the safety ofpaclitaxel in this specific clinical setting.

In an accompanying editorial, Dr Edith Perez from theUS says that the results of the study by Dr Markam andcolleagues suggest that some patients with pre-existingcardiac risk factors may be candidates for treatment withpaclitaxel.2 In her opinion, it may be time to reassess thecontraindications to treatment with paclitaxel such asconcomitant β-blocker therapy, ischaemic heart diseaseand pre-existing congestive heart failure.1. Markman M, et al. Paclitaxel administration to gynecologic cancer patients with

major cardiac risk factors. Journal of Clinical Oncology 16: 3483-3485, Nov1998.

2. Perez EA. Paclitaxel and cardiotoxicity. Journal of Clinical Oncology 16:3481-3482, Nov 1998.

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Reactions 16 Jan 1999 No. 7340114-9954/10/0734-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved