A decrease in D-dimer concentration and an occurrence of skin rash as iatrogenic events and complementary predictors of survival in lung cancer patients treated with EGFR tyrosine kinase inhibitors

Zaborowska-Szmit, Magdalena; Kowalski, Dariusz M.; Piórek, Aleksandra; Krzakowski, Maciej; Szmit, Sebastian

doi:10.1016/j.pharep.2016.07.003

Cited by 14 publications

(9 citation statements)

References 30 publications

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“…Rashes are often reported in patients treated with tyrosine kinase inhibitors (TKIs) in for a variety of cancers. Often the rash has been associated with more favorable disease outcomes and this includes lapatinib in HER2 positive breast cancer [8][9][10]. Our series was too small to determine whether infectious complications had any prognostic significance.…”

Section: Discussionmentioning

confidence: 93%

Characterization of infections and hypogammaglobulinemia treated with the combination of pertuzumab and trastuzumab

Mortimer

Kruper

Jung

et al. 2019

Cancer Chemother Pharmacol

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Purpose We update a patient series that reported a high incidence of infection with Gram-positive cocci in women treated with the combination of pertuzumab and trastuzumab and further characterize this clinical problem. Patients Treating physicians and advanced practice partners identified women who developed infections while on treatment with pertuzumab and trastuzumab alone or in combination with chemotherapy and enrolled them onto this registry trial. Results Between March, 2014 and May, 2017, 48 patients with HER2-positive breast cancers were reported to have 59 individual infections. The median age was 48 years. Twenty-four patients received neoadjuvant therapy, 17 were treated for metastatic disease, and 7 were treated in the adjuvant setting. Pertuzumab and trastuzumab were combined with carboplatin and docetaxel in 24 (49%) patients, docetaxel in 10 (21%), nab-paclitaxel in 12 (24%), and without other agents in 2 (4%). Granulocyte growth factors were administered in 24 (49%) patients and no patients were documented to be neutropenic. Folliculitis developed in 25 (52%) patients and was counted as a single infection. Abscesses developed at a number of sites in 24 (49%) patients, including a septic knee requiring total knee replacement. Paronychia occurred in 7 (15%) patients, and 5 (10%) developed cellulitis. When cultures were obtained, Gram-positive cocci were consistently identified. Hypogammaglobulinemia was documented in 14 (36%) of the 33 patients tested. Conclusions Our data continue to support an increased risk of infections with Gram-positive cocci as a potentially serious adverse event in women treated with pertuzumab and trastuzumab.

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Section: Discussionmentioning

confidence: 93%

Characterization of infections and hypogammaglobulinemia treated with the combination of pertuzumab and trastuzumab

Mortimer

Kruper

Jung

et al. 2019

Cancer Chemother Pharmacol

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“…Cardiovascular and coagulation conditions may affect overall survival in patients with cancer (31)(32)(33). Therefore, in our patients, the worst prognosis should be expected with more severe symptoms of hemodynamic instability and aggravated inflammatory process.…”

Section: Treatment Of Recurrent Pericardial Effusionmentioning

confidence: 93%

Determinants of Survival After Emergency Intrapericardial Cisplatin Treatment in Cancer Patients with Recurrent Hemodynamic Instability After Pericardiocentesis

Darocha¹,

Wilk²,

Walaszkowska-Czyż³

et al. 2018

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. Conclusion: Efficacy of rescue intrapericardial chemotherapy with cisplatin is independent of parameters of hemodynamic instability and levels of inflammatory markers in recurrent pericardial effusion.Pericardial diseases constitute an infrequent, although very serious clinical problem among oncological patients. They practically always cause deterioration of the patient's quality of life. The increasing amount of pericardial effusion and the resulting cardiac tamponade is a life-threatening condition which requires urgent diagnostics and treatment.The European Society of Cardiology (ESC) Position Paper related to cardio-oncology summarizes the knowledge on acute and chronic pericarditis as the complication resulting from anticancer treatment: some cytotoxic drugs and radiotherapy (1). Experts indicate that pericardial complications in oncology are usually associated with mediastinal tumors occupying the pericardium. The document does not discuss the issue of pericardial effusion as a potential manifestation of malignant tumor progression. The present state of knowledge concerning malignant pericarditis is based on several retrospective studies and descriptions of small groups of patients. This article presents our own prospective experience related to the treatment of patients suffering from recurrent pericardial effusion and hemodynamic instability in the course of malignant disease.The primary purpose of the observation was the assessment of determinants of overall survival of oncological patients subject to emergency pericardiocentesis and intrapericardial chemotherapy with the use of cisplatin due to recurrent symptomatic pericardial effusion and cardiac tamponade.The detailed aims included the identification of factors which could have direct impact on the overall survival of patients, these included among others: complications of pericardiocentesis and cisplatin administered intrapericardially; signs of inflammatory process: pericardial effusion culture test results, fever, white blood cell count; hemodynamic conditions: baseline level of N-terminal pro-B type natriuretic peptide (NTproBNP), volume and duration of pericardial drainage; interval for recurrence pericardial effusion; possibility of further anticancer treatment. 373

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“…Blocking the EGF by tyrosine kinase inhibitors (TKIs) may make the surface of atherosclerotic plaque more susceptible to damage. EGF receptors (EGFR), apart from affecting the endothelium, can have a more complex effect on coagulation parameters [36].…”

Section: Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitorsmentioning

confidence: 99%

Cardiovascular Complications of Systemic Therapy in Non-Small-Cell Lung Cancer

Zaborowska-Szmit

Krzakowski

Kowalski

et al. 2020

JCM

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Cardiovascular diseases may determine therapy outcomes of non-small-cell lung cancer (NSCLC). The evidence for how iatrogenic cardiovascular complications contribute to ceasing anticancer treatment, decreasing the quality of life or even premature death, is unclear. Older patients and smokers are at risk of atherosclerosis and arterial thromboembolic events (TE), such as myocardial infarction or stroke. Venous TE can be observed in up to 15% of NSCLC patients, but the risk increases three to five times in ALK (anaplastic lymphoma kinase)-rearranged NSCLC. ALK inhibitors are associated with electrophysiological disorders. Cytotoxic agents and anti-VEGF inhibitors mainly cause vascular complications, including venous or arterial TE. Cardiac dysfunction and arrhythmias seem to be less frequent. Chemotherapy is often administered in two-drug regimens. Clinical events can be triggered by different mechanisms. Among epidermal growth factor inhibitors, erlotinib and gefitinib can lead to coronary artery events; however, afatinib and osimertinib can be associated with the development of heart failure. During anti-PD1/anti-PDL1 therapy, myocarditis is possible, which must be differentiated from acute coronary syndrome and heart failure. Awareness of all possible cardiovascular complications in NSCLC encourages vigilance in early diagnostics and treatment.

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A decrease in D-dimer concentration and an occurrence of skin rash as iatrogenic events and complementary predictors of survival in lung cancer patients treated with EGFR tyrosine kinase inhibitors

Abstract: Adverse events may predict the outcomes of cancer patients. Apart from skin rash, change in D-dimer concentration may be valuable parameter in creation of predictive and prognostic models in NSCLC patients receiving anti-EGFR targeted therapy.

Cited by 14 publications

References 30 publications

Characterization of infections and hypogammaglobulinemia treated with the combination of pertuzumab and trastuzumab

Characterization of infections and hypogammaglobulinemia treated with the combination of pertuzumab and trastuzumab

Determinants of Survival After Emergency Intrapericardial Cisplatin Treatment in Cancer Patients with Recurrent Hemodynamic Instability After Pericardiocentesis

Cardiovascular Complications of Systemic Therapy in Non-Small-Cell Lung Cancer

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