Anticancer drugs cleared of CV-related hospitalization risk in colorectal cancer

Anticancer drugs do not appear to contribute to a higher incidence of cardiovascular (CV)-related hospitalization (CVRH) in metastatic colorectal cancer (mCRC) patients, according to a study.

The real-life, registry-based cohort study included 5,982 individuals who developed digestive cancers in Calvados County in France between 2008 and 2014. There were 1,116 mCRC patients (median age, 72 years; 54.7 percent male), with the tumours synchronous in 796 (71.3 percent) and metachronous in 320 (28.7 percent).

The most common form was adenocarcinoma (91.1 percent), with tumours localized in the colon in 700 patients (62.7 percent), in the rectum in 330 (29.6 percent), and in the rectosigmoid junction in 86 (7.7 percent). Half (50.4 percent) of the participants had no comorbidity.

A total of 705 (63.2 percent) patients received anticancer drugs for a total of 12,374 rounds of treatment (mean number of drugs per round, 2.0; mean number of rounds per patient, 17.5). Fluorouracil, oxaliplatin, irinotecan, and bevacizumab were the most common. Treatment was less likely to be delivered to elderly patients and women.

Over a median follow-up time of 16 months, 208 CVRH events occurred in 145 patients (13.0 percent). The International Cancer Survival Standards type 1 standardized incidence was 84.0 CVRH per 1,000 person-years. The most frequent diagnoses were ischaemic heart disease (29.3 percent), venous thromboembolism (23.7 percent), and heart failure (14.0 percent).

Multivariable Cox analysis detected no association between anticancer drugs and CVRH incidence. Male sex, older age, prior history of CVRH, and higher comorbidity were associated with an increased risk of CVRH.

Moreover, CVRH was significantly associated with a higher all-cause mortality (hazard ratio, 1.58, 95 percent confidence interval, 1.28–1.95).