[A case of advanced colon cancer with atrial fibrillation and the use of dabigatran for safe chemotherapy using fluoropyrimidine-based antitumor agents]

Gan To Kagaku Ryoho. 2013 Aug;40(8):1101-3.
[Article in Japanese]

Abstract

A 77-year-old man with colon cancer and multiple metastases to the liver and lungs underwent resection of the primary tumor and D3 lymph node dissection. He presented with chronic atrial fibrillation; therefore, warfarin was used initially as an anticoagulant. Because of the need to administer a fluoropyrimidine-based antineoplastic agent[5-fluorouracil(5-FU)] during chemotherapy, we changed the anticoagulant from warfarin to dabigatran etexilate(dabigatran)before initiating chemotherapy. No complications or excessive decrease in coagulability was observed after changing the anticoagulant; chemotherapy was safely continued. Unlike warfarin, dabigatran undergoes renal excretion, and thus, can be safely used in anticoagulant therapy without any drug interaction with 5-FU. Thus, we believe that dabigatran may be the anticoagulant of choice in the future for cancer patients who are scheduled to undergo chemotherapy using fluoropyrimidine-based antineoplastic agents.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy*
  • Benzimidazoles / therapeutic use*
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / pathology
  • Dabigatran
  • Fluorouracil / administration & dosage
  • Humans
  • Leucovorin / administration & dosage
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / secondary
  • Male
  • Organoplatinum Compounds / administration & dosage
  • Pyridines / therapeutic use*

Substances

  • Benzimidazoles
  • Organoplatinum Compounds
  • Pyridines
  • Dabigatran
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol