Researchers from the University of Auckland and Auckland City Hospital in New Zealand have begun a clinical trial aiming to improve the safety of the chemotherapy drug 5-fluorouracil.

The trial is being led by Auckland Hospital oncologist and Cancer Trials New Zealand director Dr Nicky Lawrence alongside Auckland Hospital oncologist Dr Jane So and Nuala Helsby, a professor of molecular medicine and pathology at the University of Auckland Waipapa Taumata.

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The researchers are seeking to understand why the drug has caused severe side effects in some patients over the approximately 50 years it has been in use.

Helsby said: “It’s a really old drug, but there are still all these undiscovered things about it.

“No one has put all the information together to say ‘Ah, this is why we might be seeing the side effects‘.”

Around 5% of patients treated with 5-fluorouracil experience cardiotoxicity, with rare cases leading to fatal outcomes.

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Dr Lawrence said that despite this, the drug remains the ‘backbone’ of chemotherapy treatment for stomach and bowel cancers due to its treatment potential.

The research team has secured funding for the two-year study, including NZ$149,421 ($85,541.4) from the Gut Cancer Foundation and NZ$28,968 ($16,583.8) from the University’s Te Aka Mātauranga Matepukupuku – Centre for Cancer Research.

They have received additional support for the trial from New Zealand’s Cancer Society and Canopy Cancer Care.

The trial has begun as a pilot study and aims to recruit ten patients, who will wear a Holter monitor for 48 hours to record their heart activity via an electrocardiogram (ECG).

Subjects in the trial will also undergo three blood tests and provide samples of urine.

During the trial, the research team will evaluate new software designed to detect subtle ECG changes using Holter monitor data.

They plan to expand the trial into a larger nationwide study if the pilot successfully recruits enough patients.

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