Evidence map›Paper›PMID 39886129›Full record

ArticleBMJ oncology2024

Association of pre-existing cardiovascular disease with administration of fluoropyrimidine chemotherapy in patients with gastrointestinal malignancies.

Aderonke Temilade Abiodun, Chengsheng Ju, Catherine A Welch, Jennifer Lai, Freya Tyrer, Pinkie Chambers, Lizz Paley, Sally Vernon, John Deanfield, Mark de Belder and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Aderonke Temilade AbiodunUniversity College London Institute of Cardiovascular Science, London, UK.ORCID 0000-0002-2304-3551
Chengsheng JuUniversity College London Institute of Cardiovascular Science, London, UK.
Catherine A WelchNational Disease Registration Service, NHS England, Leeds, UK.
Jennifer LaiNational Disease Registration Service, NHS England, Leeds, UK.
Freya TyrerNational Disease Registration Service, NHS England, Leeds, UK.
Pinkie ChambersResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.ORCID 0000-0002-6669-9411
Lizz PaleyNational Disease Registration Service, NHS England, Leeds, UK.
Sally VernonNational Disease Registration Service, NHS England, Leeds, UK.
John DeanfieldUniversity College London Institute of Cardiovascular Science, London, UK.
Mark de BelderNational Institute of Cardiovascular Outcomes Research (NICOR), NHS Arden and Greater East Midlands Commissioning Support Unit, Leicester, UK.
Mark RutherfordDepartment of Population Health Sciences, University of Leicester, Leicester, UK.
Paul C LambertDepartment of Population Health Sciences, University of Leicester, Leicester, UK.
Sarah SlaterBarts Cancer Centre, Barts Health NHS Trust, London, UK.
Kai Keen ShiuCancer Division, University College London Hospitals NHS Foundation Trust, London, UK.
Li WeiResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Michael D PeakeDepartment of Respiratory Medicine, University of Leicester, Glenfield Hospital, Leicester, UK.
VICORI collaborative
David AdlamDepartment of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Glenfield Hospital, Leicester, UK.
Charlotte ManistyUniversity College London Institute of Cardiovascular Science, London, UK.ORCID 0000-0003-0245-7090

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Fluoropyrimidine chemotherapy is a first-line treatment for many gastrointestinal (GI) cancers, however, cardiotoxicity concerns may limit administration in patients with pre-existing cardiovascular disease (CVD). This study investigated the association of pre-existing CVD with use of fluoropyrimidine chemotherapy in tumour-eligible GI cancer patients. Methods and analysis: National cancer registry data from the Virtual Cardio-Oncology Research Initiative from England between 2014 and 2018 was used to identify GI cancer patients eligible to receive fluoropyrimidine chemotherapy. Linkage to Hospital Episode Statistics and CVD registry data were used to ascertain prior CVD and outcomes. Primary outcome was first administration of fluoropyrimidine chemotherapy following cancer diagnosis. Cox proportional hazard models determined HR and 95% CIs for the association between initiation of fluoropyrimidine treatment and prior CVD. Results: 112 726 eligible patients were identified (median age 71 years (IQR 62-80), 39.7% female). 33 026 (29.3%) had pre-existing CVD. 73 392 (65.1%) patients had a diagnosis of colorectal, 23 208 (20.6%) oesophageal, 14 788 (13.1%) gastric and 1338 (1.2%) small bowel cancer. Individuals with pre-existing CVD had a 27% reduced rate of receiving fluoropyrimidine chemotherapy (HR, 0.73; 95% CI 0.70 to 0.75) on multivariable analysis. Significantly reduced rates of fluoropyrimidine administration were found across all subtypes of pre-existing CVD. Conclusions: GI cancer patients with all types of pre-existing CVD are less likely to receive fluoropyrimidine chemotherapy despite eligibility. This suggests widespread caution regarding administration of fluoropyrimidines across this population; further research is needed to assess whether such conservatism is justified.

Indexed as

ChemotherapyColorectal cancerGastric cancerOesophageal cancer

Identifiers

PMID39886129
PMCPMC11347681

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.