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First Case of Foot Drop Associated with Capecitabine in a Patient with Thymidylate Synthase Polymorphism.
Cureus 2017; 9(1):e995C

Abstract

Capecitabine, an oral prodrug of 5-FU, has been approved by the FDA for use in patients with breast and colon cancers. In addition, capecitabine is commonly used in patients with other malignancies such as pancreatic, gastroesophageal, and hepatobiliary tract cancers. Though cerebellar toxicity is a rare but well-known side effect of intravenous 5-FU therapy, peripheral neuropathy with capecitabine has only been described in rare cases. In this case report, we describe a 79-year-old patient with locally advanced adenocarcinoma of the pancreas undergoing chemoradiation therapy with capecitabine who developed peripheral sensorimotor neuropathy. To the best of our knowledge, this is the first patient in the literature who was found to have two mutations (2R) of a 28 base-pair tandem repeat in the 5' promoter enhancer region (5'-TSER) on both alleles (2R/2R) of thymidylate synthetase (TYMS) gene, possibly responsible for the neurotoxicity.

Authors+Show Affiliations

Tufts Medical Center, Tufts University School of Medicine.Hematology/Oncology, Tufts Medical Center, Tufts University School of Medicine.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

28280649

Citation

Wilks, Andrew B., and Muhammad W. Saif. "First Case of Foot Drop Associated With Capecitabine in a Patient With Thymidylate Synthase Polymorphism." Cureus, vol. 9, no. 1, 2017, pp. e995.
Wilks AB, Saif MW. First Case of Foot Drop Associated with Capecitabine in a Patient with Thymidylate Synthase Polymorphism. Cureus. 2017;9(1):e995.
Wilks, A. B., & Saif, M. W. (2017). First Case of Foot Drop Associated with Capecitabine in a Patient with Thymidylate Synthase Polymorphism. Cureus, 9(1), pp. e995. doi:10.7759/cureus.995.
Wilks AB, Saif MW. First Case of Foot Drop Associated With Capecitabine in a Patient With Thymidylate Synthase Polymorphism. Cureus. 2017 Jan 24;9(1):e995. PubMed PMID: 28280649.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - First Case of Foot Drop Associated with Capecitabine in a Patient with Thymidylate Synthase Polymorphism. AU - Wilks,Andrew B, AU - Saif,Muhammad W, Y1 - 2017/01/24/ PY - 2017/3/11/entrez PY - 2017/3/11/pubmed PY - 2017/3/11/medline KW - 5-fluorouracil KW - capecitabine KW - dihydropyrimidine dehydrogenase (dpd) KW - foot drop KW - peripheral neuropathy KW - pharmacogenetics KW - thymidylate synthase (ts) SP - e995 EP - e995 JF - Cureus JO - Cureus VL - 9 IS - 1 N2 - Capecitabine, an oral prodrug of 5-FU, has been approved by the FDA for use in patients with breast and colon cancers. In addition, capecitabine is commonly used in patients with other malignancies such as pancreatic, gastroesophageal, and hepatobiliary tract cancers. Though cerebellar toxicity is a rare but well-known side effect of intravenous 5-FU therapy, peripheral neuropathy with capecitabine has only been described in rare cases. In this case report, we describe a 79-year-old patient with locally advanced adenocarcinoma of the pancreas undergoing chemoradiation therapy with capecitabine who developed peripheral sensorimotor neuropathy. To the best of our knowledge, this is the first patient in the literature who was found to have two mutations (2R) of a 28 base-pair tandem repeat in the 5' promoter enhancer region (5'-TSER) on both alleles (2R/2R) of thymidylate synthetase (TYMS) gene, possibly responsible for the neurotoxicity. SN - 2168-8184 UR - https://www.unboundmedicine.com/medline/citation/28280649/First_Case_of_Foot_Drop_Associated_with_Capecitabine_in_a_Patient_with_Thymidylate_Synthase_Polymorphism_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/28280649/ DB - PRIME DP - Unbound Medicine ER -