Chao Li

Although new cancer treatments have been increasingly developed, fluoropyrimidines, such as 5-fluorouracil (5-FU) and capecitabine, are widely used alone or in combination as chemotherapy to treat cancer, especially for colorectal cancer. However, these drugs are associated with serious adverse events like heart damage (cardiotoxicity), which could result in emergency department visits, hospitalizations, and even sudden death. Understanding the risk and risk factors will help physicians with early prediction of fluoropyrimidine-induced cardiotoxicity (FIC) and improvement in patient monitoring. Several attempts to identify potential risk factors for FIC have been made, however, the evidence is not compelling due to a lack of robust data and limitations of traditional methodological approach. In this project, up-to-date published evidence regarding risk factors of FIC will be reviewed and summarized to assess the risk of FIC in broad cancer patients (Aim 1). Then, a large registry-claims linked, population-level data of older colorectal cancer patients will be used to evaluate the risk of FIC by types of chemotherapy treatments (Aim 2). Last, a novel data-analysis approach will be employed to develop new criteria for predicting the adverse cardiotoxicity events among colorectal cancer patients who used fluoropyrimidine treatments (Aim 3). Findings generated from this study will have important implications for identifying cancer subgroups at high risk of FIC, which could help clinicians make better clinical decisions in treatment selection and patient monitoring.