Acute Coronary Syndrome Occurring in a Sub-Saharan Patient Treated with a Reduced Dose of Sorafenib for an Unresectable Hepatocellular Carcinoma: Case Report
- 1 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 2 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 3 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 4 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 5 Hepatogastroenterology and Oncology Unit, Yaoundé General Hospital, Yaounde, Cameroon
- 6 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 7 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 8 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 9 Hepatogastroenterology and Oncology Unit, Yaoundé General Hospital, Yaounde, Cameroon
- 10 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 11 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 12 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 13 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
Abstract
Sorafenib is a chemotherapy used as first line treatment in primary liver cancers. It is an oral antiangiogenic treatment which reduces the progression of the tumor. Some mild or severe side effects have been reported among which some uncommon cardiac events: myocardial infarction and cardiogenic stroke. Sorafenib treatment remains expensive and not frequently used in Sub-Saharan countries. Thus, few studies have described its side effects in this milieu. We report a case of acute coronary syndrome occurring in a 75-year-old female patient, without cardiovascular risks factors, after nine months of sorafenib chemotherapy at a reduced dose for an unresectable hepatocellular carcinoma in a Sub-Saharan Africa country. The management was conducted by cardiologists, in collaboration with gastroenterologists and oncologists. We decided to completely stop sorafenib chemotherapy. We observed a reduction of the pain 48 hours after her admission, and a regression of electrocardiographic signs after 8 days. In conclusion, the sorafenib treatment can be associated with cardiac events despite the dose reduction.
- Llovet, J.M., Ricci, S., Mazzaferro, V., Hilgard, P., Gane, E., Blanc, J.F., de Oliveira, A.C., Santoro, A., Raoul, J.L., Forner, A., Schwartz, M., et al. (2008) Sorafenib in Advanced Hepatocellular Carcinoma. The New England Journal of Medicine, 359, 378-390. https://doi.org/10.1056/NEJMoa0708857
- Wang, S.X., Byrnes, A., Verma, S., Pancoast, J.R. and Rixe, O. (2010) Complete Remission of Unresectable Hepatocellular Carcinoma Treated with Reduced Dose of Sorafenib. A Case Report. Target Oncology, 5, 59-63. https://doi.org/10.1007/s11523-010-0133-x
- Ozenne, V., Paradis, V., Pernot, S., Cateinau, C., Vullierme, M.P., Bouattour, M., Valla, D., Farges, O. and Degos, F. (2010) Tolerance and Outcome of Patients with Unresectable Hepatocellular Carcinoma Treated with Sorafenib. European Journal Gastroenterology Hepatology, 22, 1106-1110. https://doi.org/10.1097/MEG.0b013e3283386053
- Liu, L., Cao, Y., Chen, C., Zhang, X., McNabola, A., et al. (2006) Sorafenib Blocks the RAF/MEK/ERK Pathway, Inhibits Tumor Angiogenesis, and Induces Tumor Cell Apoptosis in Hepatocellular Carcinoma Model PLC/PRF/5. Cancer Research, 66, 11851-11858. https://doi.org/10.1158/0008-5472.CAN-06-1377
- Pantaleo, M.A., et al. (2012) Development of Coronary Artery Stenosis in a Patient with Metastatic Renal Cell Carcinoma Treated with Sorafenib. BMC Cancer, 12, Article No. 231. https://doi.org/10.1186/1471-2407-12-231
- Arima, Y. and Ogawa, H. (2009) Sorafenib-Induced Acute Myocardial Infarction Due to Coronary Artery Spasm. Journal of Cardiology, 54, 512-515. https://doi.org/10.1016/j.jjcc.2009.03.009
- Calistri, L., Cordopatri, C., et al. (2017) Sudden Cardiac Death in a Patient with Advanced Hepatocellular Carcinoma with Good Response to Sorafenib Treatment: A Case Report with Literature Analysis. Molecular and Clinical Oncology, 6, 389-396. https://doi.org/10.3892/mco.2017.1132
- Wu, C. and Shemisa, K. (2017) Sorafenib-Associated Heart Failure Complicated by Cardiogenic Shock after Treatment of Advanced Stage Hepatocellular Carcinoma. Case Report in Cardiology, 2017, Article ID: 7065759. https://doi.org/10.1155/2017/7065759
- Naib, T., Steingart, R.M. and Chen, C.L. (2011) Sorafenib-Associated Multivessel Coronary Artery Vasospasm. Herz, 36, 348-351. https://doi.org/10.1007/s00059-011-3444-5
- Pons, F., Varela, M. and Josep, M. (2005) Staging Systems in Hepatocellular Carcinoma. HPB, 7, 35-41. https://doi.org/10.1080/13651820410024058