Case report and review of literature: temporary asymptomatic sinus bradycardia with carboplatin, paclitaxel and bevacizumab: under-reported in clinical trials and under-disclosed in practice

ABSTRACT

Paclitaxel, Carboplatin, and Bevacizumab [PCB] is one of the standard chemotherapy regimens for the treatment of non-small cell lung cancer. Temporary asymptomatic bradycardia is recognized toxicity of paclitaxel. However, it is under-disclosed to patients during consent for treatment and is under-reported in clinical phase III trials. Here, were report a case of severe but temporary asymptomatic sinus bradycardia [heart rate 39 bpm] in a patient immediately after receiving PCB. The patient was not informed of this risk during consent to therapy leading to non-compliance with future plan of management. Literature search showed that bradycardia is documented. However, it is not reported adequately in land mark phase III trials' reports. The cause of bradycardia in this patient is probably paclitaxel. Oncologists should disclose this potential risk to patients during consent to chemotherapy. Investigators should monitor and report it when conducting land mark trials