A case of reversible cardiomyopathy associated with sorafenib in advanced hepatocellular carcinoma

Park, Hyekyong; Han, Seung-Hee; Kang, Hyo-Jin; Park, Kyungil

doi:10.1016/j.ijcard.2011.12.114

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…Myocardial cells require greater energy demands than other cells and therefore are particularly sensitive to deficiencies in energy production. Some case reports have indicated the potential for reversibility of sorafenib-induced cardiomyopathy after discontinuation though it is unclear to what extent or after what duration of treatment that reversibility is still feasible [17]. …”

Section: Discussionmentioning

confidence: 99%

Sorafenib-Associated Heart Failure Complicated by Cardiogenic Shock after Treatment of Advanced Stage Hepatocellular Carcinoma: A Clinical Case Discussion

Shemisa

2017

Case Reports in Cardiology

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Background. Sorafenib, an oral tyrosine kinase inhibitor (TKI), targets multiple tyrosine kinase receptors (TKRs) involved in angiogenesis and tumor growth. Studies suggest that inhibition of TKR impacts cardiomyocyte survival. Inhibition of VEGF signaling interrupts angiogenesis and is associated with the development of hypertension and compensatory hypertrophy. Compensated hypertrophy ultimately leads to heart failure. Case Description. A 76-year-old man with a past medical history of systolic heart failure due to ischemic cardiomyopathy and stage IIIC hepatocellular carcinoma (HCC) presented with symptoms of decompensated heart failure. Four months prior to admission, he was started on sorafenib. Results. Our patient was treated with intravenous furosemide and guideline directed therapy. Clinical status was complicated by the development of low cardiac output and shock requiring inotropic support. Careful titration of heart failure medication led to hemodynamic improvement and discontinuation of dobutamine. Conclusion. Greater awareness of sorafenib cardiotoxicity is essential. As TKI usage grows for treatment of cancers, heart failure-related complications will increase. In our patient, routine heart failure management and cessation of sorafenib led to clinical improvement. Future studies on the treatment of sorafenib cardiotoxicity should be explored further in this unique patient population.

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Section: Discussionmentioning

confidence: 99%

Sorafenib-Associated Heart Failure Complicated by Cardiogenic Shock after Treatment of Advanced Stage Hepatocellular Carcinoma: A Clinical Case Discussion

Shemisa

2017

Case Reports in Cardiology

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Takotsubo Syndrome in a Patient with Metastatic Renal Cell Carcinoma Treated with Pembrolizumab Plus Axitinib

et al. 2022

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We report the case of a patient with metastatic renal cell carcinoma who developed Takotsubo syndrome (TTS) 6 days after starting pembrolizumab plus axitinib as first-line treatment. Coronary angiogram was negative for obstructive coronary artery disease and echocardiogram revealed a depressed left ventricular ejection fraction with apical akinesis. Axitinib was discontinued and myocardial contractile function fully recovered 23 days after the initial presentation. The treatment was safely resumed and granted a partial response of disease. A literature review regarding TTS in patients receiving VEGFR tyrosine kinase inhibitors and/or immune checkpoint inhibitors was performed. TTS is reported as a rare adverse event and the possible causal relationship between TTS and antineoplastic therapy is still unclear. Further research is warranted to better understand cardiotoxicity mechanisms and their management.

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A case of reversible cardiomyopathy associated with sorafenib in advanced hepatocellular carcinoma

Cited by 2 publications

References 7 publications

Sorafenib-Associated Heart Failure Complicated by Cardiogenic Shock after Treatment of Advanced Stage Hepatocellular Carcinoma: A Clinical Case Discussion

Sorafenib-Associated Heart Failure Complicated by Cardiogenic Shock after Treatment of Advanced Stage Hepatocellular Carcinoma: A Clinical Case Discussion

Takotsubo Syndrome in a Patient with Metastatic Renal Cell Carcinoma Treated with Pembrolizumab Plus Axitinib

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