Antineoplastics
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Reactions 1430 - 1 Dec 2012 S Antineoplastics Various toxicities: 2 case reports Two men developed various toxicities following sequential antineoplastic therapy for metastatic renal cell carcinoma (RCC). A 53-year-old man received sunitinib 50 mg/day [route not stated] for 4 weeks with a 2-week washout phase alongside vinorelbine, bevacizumab and zolendronic acid. He experienced mild hypertension due to sunitinib which was successfully treated with an angiotensin receptor antagonist [time to reaction onset and duration of treatment before reaction not stated]. He achieved a partial response although his disease subsequently relapsed and sunitinib was switched to temsirolimus 25 mg/week [route not stated]. His condition deteriorated further and sorafenib and bevacizumab were added. He subsequently experienced grade III anaemia due to temsirolimus and was treated with erythropoiesis-stimulating agents and blood transfusions [time to reaction onset, duration of treatment before reaction and outcome not stated]. He subsequently died of an uncontrollable allergic shock during a blood transfusion possibly due to an indirect effect of temsirolimus-induced anaemia. A 54-year-old man received sunitinib 50 mg/day [route not stated] for 4 weeks with a 2-week washout phase. He developed hypothyroidism 6 months after initiating sunitinib which was treated with levothyroxine [outcome not stated]. His disease continued to progress despite treatment with temsirolimus and zolendronic acid so sorafenib 400 mg/day [route not stated] was initiated. He experienced mild asthenia, grade I myelosupression and hyperlipidemia due to sorafenib although no treatment delay or dose reduction was necessary [time to reaction onset, duration of treatment before reaction and outcome not stated]. Further pulmonary metastases occurred and pazopanib 800 mg/day was initiated. Despite experiencing anorexia and grade II diarrhoea due to pazopanib he achieved stable disease [time to reaction onset, duration of treatment before reaction and outcome not stated]. Author comment: "[W]e present two patients whose RCC was treated with nephrectomy, metastasectomies, and sequential systemic therapy and who experienced a very satisfactory quality of life and long-term survival". Syrios J, et al. Prolonged survival after sequential multimodal treatment in metastatic renal cell carcinoma: Two case reports and a review of the literature. Journal of Medical Case Reports 6: [6 pages], No. 303, 14 Sep 2012. Available from: URL: http://dx.doi.org/10.1186/1752-1947-6-303 - Greece 803080574 1 Reactions 1 Dec 2012 No. 1430 0114-9954/10/1430-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1430 - 1 Dec 2012
SAntineoplastics
Various toxicities: 2 case reportsTwo men developed various toxicities following
sequential antineoplastic therapy for metastatic renal cellcarcinoma (RCC).
A 53-year-old man received sunitinib 50 mg/day [routenot stated] for 4 weeks with a 2-week washout phasealongside vinorelbine, bevacizumab and zolendronic acid.He experienced mild hypertension due to sunitinib whichwas successfully treated with an angiotensin receptorantagonist [time to reaction onset and duration oftreatment before reaction not stated]. He achieved a partialresponse although his disease subsequently relapsed andsunitinib was switched to temsirolimus 25 mg/week [routenot stated]. His condition deteriorated further andsorafenib and bevacizumab were added. He subsequentlyexperienced grade III anaemia due to temsirolimus and wastreated with erythropoiesis-stimulating agents and bloodtransfusions [time to reaction onset, duration of treatmentbefore reaction and outcome not stated]. He subsequentlydied of an uncontrollable allergic shock during a bloodtransfusion possibly due to an indirect effect oftemsirolimus-induced anaemia.
A 54-year-old man received sunitinib 50 mg/day [routenot stated] for 4 weeks with a 2-week washout phase. Hedeveloped hypothyroidism 6 months after initiatingsunitinib which was treated with levothyroxine [outcomenot stated]. His disease continued to progress despitetreatment with temsirolimus and zolendronic acid sosorafenib 400 mg/day [route not stated] was initiated. Heexperienced mild asthenia, grade I myelosupression andhyperlipidemia due to sorafenib although no treatmentdelay or dose reduction was necessary [time to reactiononset, duration of treatment before reaction and outcomenot stated]. Further pulmonary metastases occurred andpazopanib 800 mg/day was initiated. Despite experiencinganorexia and grade II diarrhoea due to pazopanib heachieved stable disease [time to reaction onset, duration oftreatment before reaction and outcome not stated].
Author comment: "[W]e present two patients whose RCCwas treated with nephrectomy, metastasectomies, andsequential systemic therapy and who experienced a verysatisfactory quality of life and long-term survival".Syrios J, et al. Prolonged survival after sequential multimodal treatment inmetastatic renal cell carcinoma: Two case reports and a review of the literature.Journal of Medical Case Reports 6: [6 pages], No. 303, 14 Sep 2012. Availablefrom: URL: http://dx.doi.org/10.1186/1752-1947-6-303 - Greece 803080574
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Reactions 1 Dec 2012 No. 14300114-9954/10/1430-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
