ArticleCancer2017
Emergency use of uridine triacetate for the prevention and treatment of life-threatening 5-fluorouracil and capecitabine toxicity.
Article in Cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 1 of them a synthesis that pooled it.
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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.
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.
Who cites it
54 citing papers in PubMed, 1 synthesis or guideline pooled it, 121 citations in OpenAlex.
- Therapeutic Drug Monitoring in Oncology: International Association of Therapeutic Drug Monitoring and Clinical Toxicology Recommendations for 5-Fluorouracil Therapy.Clinical pharmacology and therapeutics · 2019Guideline
- Ischemic heart disease and cardio-onco-hematology: a comprehensive review.Cardio-oncology (London, England) · 2026Review
- Article
- Severe acute myocarditis induced by 5-fluorouracil with successful rechallenge after multidisciplinary cardio-oncology evaluation: a case report.European heart journal. Case reports · 2026Article
- Navigating Cardiotoxicity in Cancer Treatment: Insights into Fluoropyrimidine-induced Cardiac Events.Current cardiology reviews · 2026Review
- A case of folinic acid, fluorouracil and oxaliplatin (FOLFOX) chemotherapy regimen associated neurotoxicity and review of literature.BMC neurology · 2025Review
- CF10 Displayed Improved Activity Relative to 5-FU in a Mouse CRLM Model Under Conditions of Physiological Folate.Cancers · 2025Article
- 5-Fluorouracil Toxicity: Revisiting the Relevance of Pharmacokinetic Parameters.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Economic Model of Uridine Triacetate Versus Supportive Care for the Treatment of Patients with Life-Threatening Early-Onset Severe Toxicity.Clinical drug investigation · 2025Article
- Taxifolin Protects Against 5-Fluorouracil-Induced Cardiotoxicity in Mice Through Mitigating Oxidative Stress, Inflammation, and Apoptosis: Possible Involvement of Sirt1/Nrf2/HO-1 Signaling.Cardiovascular toxicology · 2025Article
- Super-enhancer Activates Master Transcription Factor NR3C1 Expression and Promotes 5-FU Resistance in Gastric Cancer.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Dihydropyrimidine enzyme activity and its effect on chemotherapy toxicity: importance of genetic testing.Cancer chemotherapy and pharmacology · 2025Article
- Long-Term Outcomes of 5-Fluorouracil-Related Early-Onset Toxicities: A Retrospective Cohort Study.Cancers · 2024Article
- Overcoming Barriers to Discovery and Implementation of Equitable Pharmacogenomic Testing in Oncology.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Review
- Management of Fluoropyrimidine-Induced Cardiac Adverse Outcomes Following Cancer Treatment.Cardiovascular toxicology · 2024Review
- Laherradurin Inhibits Tumor Growth in an Azoxymethane/Dextran Sulfate Sodium Colorectal Cancer Model In Vivo.Cancers · 2024Article
- Uridine and its role in metabolic diseases, tumors, and neurodegenerative diseases.Frontiers in physiology · 2024Review
- 5-Fluorouracil Neurotoxicity in a Patient With Normal Dihydropyrimidine Dehydrogenase Activity.Cureus · 2023Article
- Cardiogenic shock after 5-fluorouracil administration: a case report and literature review.European heart journal. Case reports · 2023Article
- Oral Capecitabine Exposures and Use of Uridine Triacetate: A 20-Year Retrospective Analysis.Clinical drug investigation · 2023Article
Corrections and comments
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Authors and funding
9 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncreased susceptibility to 5-fluorouracil (5-FU)/capecitabine can lead to rapidly occurring toxicity caused by impaired clearance, dihydropyrimidine dehydrogenase deficiency, and other genetic variations in the enzymes that metabolize 5-FU. Life-threatening 5-FU overdoses occur because of infusion pump errors, dosage miscalculations, and accidental or suicidal ingestion of capecitabine. Uridine triacetate (Vistogard) was approved in 2015 for adult and pediatric patients who exhibit early-onset severe or life-threatening 5-FU/capecitabine toxicities or present with an overdose. Uridine triacetate delivers high concentrations of uridine, which competes with toxic 5-FU metabolites.
methodsIn 2 open-label clinical studies, patients who presented with a 5-FU/capecitabine overdose or an early onset of severe toxicities were treated. Patients received uridine triacetate as soon as possible (most within the first 96 hours after 5-FU/capecitabine). Outcomes included survival, resumption of chemotherapy, and safety. Their survival was compared with the survival of a historical cohort of overdose patients who received only supportive care.
resultsA total of 137 of 142 overdose patients (96%) treated with uridine triacetate survived and had a rapid reversal of severe acute cardiotoxicity and neurotoxicity; in addition, mucositis and leukopenia were prevented, or the patients recovered from them. In the historical cohort, 21 of 25 patients (84%) died. Among the 141 uridine triacetate-treated overdose patients with a diagnosis of cancer (the noncancer patients included 6 intentional or accidental pediatric overdoses), 53 resumed chemotherapy in < 30 days (median time after 5-FU, 19.6 days), and this indicated a rapid recovery from toxicity. Adverse reactions in patients receiving uridine triacetate included vomiting (8.1%), nausea (4.6%), and diarrhea (3.5%).
conclusionsIn these studies, uridine triacetate was a safe and effective lifesaving antidote for capecitabine and 5-FU overexposure, and it facilitated the rapid resumption of chemotherapy. Cancer 2017;123:345-356. © 2016 American Cancer Society.
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