Journal of Clinical Oncology, 2005 ASCO Annual Meeting Proceedings.
Vol 23, No 16S (June 1 Supplement), 2005: 8259
© 2005 American Society of Clinical Oncology

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Abstract

Tropisetron does not induce arrhythmia in chemo-naive otherwise healthy cancer patients

H. Abali, G. Abal, B. Öksüzoglu, M. Bakar, B. Budakoglu, B. Oyan, K. Aytemur and N. Zengin

S. B. Ankara Numune Eitim ve Arat, Ankara, Turkey; Hacettepe Universitesi Tp Fakültesi, Ankara, Turkey

8259

Background: Chemotherapy induced emesis is one of the most distressing side effects of chemotherapy. Serotonin antagonists revolutionized its management. Although they are considered as relatively safe agents, they have significant cardiovascular side effects: Ondansetron and dolasetron are known to prolong corrected QT interval (QTc), which is a good predictor of arrhythmia. Package insert of tropisetron carries a warning against cardiovascular events and data on its cardiovascular effects are sparse. Our aim was to investigate the effects of tropisetron alone before combination chemotherapy on electrocardiographic parameters of patients with cancer. Methods: All the patients were monitorized with high resolution holter monitor (Ela Medical Inc.). Approximately 10 minutes after holter monitoring onset, 5 mg tropisetron was given intravenously, then 1 hour was allowed to elapse until chemotherapy administration to compare baseline values of QTc and QT dispersion with those during injection and the following 1 hour period in chemo-naive otherwise healthy cancer patients. Eleven patients, median age 45 years, without prior cardiovascular co-morbidities were enrolled. Ten (91%) patients were females with breast cancer and 1 (9%) was male with lymphoma. Results: In pre-tropisetron period, 3 patients (27.3%) had non-significant arrhythmias (2 supravetricular extrasystole [SVES] and 1 ventricular extrasystole [VES]). In during- and after-tropisetron period, 2 additional patients developed SVES and 3 developed bradycardia below 50 beats/minute (collectively 72.7%). Patients were asymptomatic and there was no statistical significance (Mc Nemar, p=0.063) in frequencies. QTc before (375msecs) and after (370 msecs) tropisetron injection were not different (Wilcoxon Signed Ranks Test, p=0.098), as was QT dispersion (30 vs. 40msecs, Wilcoxon Signed Ranks Test, p=0.180). There were no life threatening arrhythmias observed. Conclusions: Tropisetron did not seem to induce significant or non-significant arrhythmias. Predictors of arrhythmias were not affected, either. However, the number of patients is few and we continue to enroll patients.

No significant financial relationships to disclose.