Congestive heart failure secondary to gemcitabine nab-paclitaxel in patients with pancreatic cancer

Preethi John, Harriet Butler, Muhammad Wasif Saif

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Gemcitabine plus nab-paclitaxel is a novel combination chemotherapy that is currently being used in patients with metastatic pancreatic cancer. Phase III trials have shown improved survival, response rates, and disease-free progression. The most significant side-effects include peripheral neuropathy and myelotoxicity. Review of literature has shown rare cases of congestive heart failure associated with gemcitabine plus nab-paclitaxel. We describe two cases of women who were treated with gemcitabine plus nab-paclitaxel for pancreatic adenocarcinoma who developed acute exacerbation of congestive heart failure. Patients and Methods: Two women with pancreatic adenocarcinoma were both treated with gemcitabine plus nab-paclitaxel and developed acute decompensated heart failure requiring hospitalization and standard treatment for heart failure including i.v. diuretics. Once chemotherapy was discontinued, symptoms resolved. Conclusion: Based on review of literature, as far as we are aware of, this is the first report of congestive heart failure as an adverse effect of combination therapy. Both patients had evidence of diastolic dysfunction which may have predisposed them to cardiac toxicity secondary to gemcitabine plus nab-paclitaxel. The exact mechanism of action is currently unknown and requires further studies. However, it is imperative for physicians to be aware of this adverse effect and closely monitor patients with underlying heart disease who are undergoing treatment with gemcitabine plus nab-paclitaxel.

Original languageEnglish (US)
Pages (from-to)7267-7270
Number of pages4
JournalAnticancer Research
Issue number12
StatePublished - Dec 1 2014
Externally publishedYes


  • Congestive heart failure
  • Gemcitabine
  • Nab-paclitaxel
  • Pancreatic cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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