Rapid and fatal acute heart failure induced by pazopanib.

Abstract

Tyrosine kinase inhibitors, represented by sunitinib, sorafenib, axitinib and pazopanib, are emerging molecules harbouring antitumoural efficacy in multiple neoplasia. We report the case of a 51-year-old woman with right thoracic sarcoma who developed fatal heart failure on pazopanib. The patient had no cardiovascular risk factor, except previous exposure to anthracycline, and her cardiac function was normally controlled before initiating the pazopanib. Despite a rapid tumour response, fatigue rapidly appeared, requiring treatment interruption 2 weeks after pazopanib introduction. After clinical improvement, the pazopanib was reintroduced at reduced dose; however, a few days later, our patient was admitted for worsening dyspnoea and fatigue. Pulmonary embolism was excluded as was pleuropericardial effusion. Brain natriuretic peptide was the only laboratory abnormality, and echocardiography revealed acute and severe heart failure. The patient died despite pazopanib arrest and inotropic support.

• Authors: Cédric van Marcke, Benjamin Ledoux, Bénédicte Petit, Emmanuel Seront
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2015 (Sep 02 2015) ISSN: 1757-790X [Electronic] England
• PMID: 26336188 (Publication Type: Case Reports, Journal Article)
• Copyright: 2015 BMJ Publishing Group Ltd.

Chemical References

• Antineoplastic Agents
• Indazoles
• Pyrimidines
• Sulfonamides
• pazopanib

Topics

• Antineoplastic Agents (adverse effects)
• Dyspnea (chemically induced)
• Fatal Outcome
• Fatigue (chemically induced)
• Female
• Heart Failure (chemically induced)
• Humans
• Indazoles
• Middle Aged
• Pyrimidines (adverse effects)
• Sarcoma, Synovial (drug therapy)
• Sulfonamides (adverse effects)
• Thoracic Neoplasms (drug therapy)