Appropriate Management of Cutaneous Adverse Events Maximizes Compliance with Sorafenib Treatment: A Single-Center Experience

Scandurra, Giuseppa; Aiello, Rosa; Alì, Marco; Taibi, Eleonora; Sanò, Maria Vita; Todaro, Francesco Maurizio; Rocca, Rosaria La; Licciardello, Paolo; Caruso, Michele

doi:10.2217/fon.12.35

Cited by 11 publications

(11 citation statements)

References 20 publications

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“…Finally, the analysis by group of OAA revealed sorafenib to be the drug with the highest number of AE. The high toxicity of sorafenib in clinical practice has been reported elsewhere (Scandurra et al 2012).…”

Section: Discussionmentioning

confidence: 88%

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Pharmacotherapy follow-up of key points in the safety of oral antineoplastic agents

et al. 2016

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We assessed the impact of a pharmacotherapy follow-up programme on key safety points [adverse events (AE) and drug administration] in outpatients treated with oral antineoplastic agents (OAA). We performed a comparative, interventional, quasi-experimental study of outpatients treated with OAA in a Spanish hospital to compare pre-intervention group patients (not monitored by pharmacists during 2011) with intervention group patients (prospectively monitored by pharmacists during 2013). AE data were collected from medical records. Follow-up was 6 months, and 249 patients were included (pre-intervention, 115; intervention, 134). After the first month, AE were detected in 86.5% of patients in the pre-intervention group and 80.6% of patients in the intervention group, P = 0.096. During the remaining months, 79.0% patients had at least one AE in the pre-intervention group compared with 78.0% in the intervention group, P = 0.431. AE were more prevalent with sorafenib and sunitinib. In total, 173 drug interactions were recorded (pre-intervention, 80; intervention, 93; P = 0.045). Drug interactions were more frequent with erlotinib and gefitinib; food interactions were more common with sorafenib and pazopanib. Our follow-up of cancer outpatients revealed a reduction in severe AE and major drug interactions, thus helping health professionals to monitor the safety of OAA.

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Section: Discussionmentioning

confidence: 88%

“…The high toxicity of sorafenib in clinical practice has been reported elsewhere (Scandurra et al . ).…”

Section: Discussionmentioning

confidence: 97%

Pharmacotherapy follow-up of key points in the safety of oral antineoplastic agents

et al. 2016

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“…Management of HFSR, diarrhoea and hypertension is especially important; although they are associated with positive treatment outcomes, they are among the most frequently experienced AEs [2][3][4][5]. Furthermore, if TKI tolerability can be improved, patients are more likely to remain on treatment and therefore experience better outcomes [29,30].…”

Section: Association Of Tki Aes With Positive Treatment Outcomesmentioning

confidence: 99%

Management of adverse events associated with tyrosine kinase inhibitors: Improving outcomes for patients with hepatocellular carcinoma

Rimassa

Danesi

Pressiani

et al. 2019

Cancer Treatment Reviews

175

163

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Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer. Sorafenib, regorafenib, lenvatinib and cabozantinib are tyrosine kinase inhibitors (TKIs) that target, in part, vascular endothelial growth factor receptors, and are approved in various regions of the world for the treatment of advanced HCC. All these agents are associated with a range of adverse events (AEs) that can have a substantial impact on patients' healthrelated quality of life. Fatigue, diarrhoea, hand-foot skin reaction, nausea, vomiting, decreased appetite, hypertension and weight loss are among the most common AEs experienced with these four TKIs. In this review, we discuss strategies for the management of these AEs in patients with advanced HCC, with the aim of maximizing treatment benefits and minimizing the need for TKI treatment discontinuation. We also consider potential TKI-drug interactions and discuss the use of TKIs in patients with liver dysfunction or who have experienced tumour recurrence after liver transplantation. Use of appropriate AE management strategies and avoidance of contraindicated drugs should help patients with advanced HCC to achieve optimal outcomes with TKIs.

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“…To this end, a wide variety of recommendations have been developed by multidisciplinary teams and are available in order to guide physicians in their management of the most common AEs associated with sorafenib [35][36][37][38][39][40][41]. Recommendations for managing HFSR, diarrhea, fatigue, and hypertension are shown in table 6 and Boxes 1-4.table…”

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confidence: 99%

Refining Sorafenib Therapy: Lessons from Clinical Practice

et al. 2014

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AbstrAct:Understanding the best use of sorafenib is essential in order to maximize clinical benefit in hepatocellular carcinoma. Based on Phase III and noninterventional study data, as well as our extensive experience, we discuss dose modification in order to manage adverse events, disease response evaluation and how to maximize treatment benefit. Sorafenib should be initiated at the approved dose (400 mg twice daily) and reduced/ interrupted as appropriate in order to manage adverse events. Dose modification should be considered before discontinuation. Appropriate tumor response assessment is critical. Focusing on radiologic response may result in premature sorafenib discontinuation; symptomatic progression should also be considered. If second-line therapies or trials are unavailable, continuing sorafenib beyond radiologic progression may provide a clinical benefit. Our recommendations enable the maximization of treatment duration, and hence clinical benefit, for patients. Keywords:• adverse event managementIt is well established that hepatocellular carcinoma (HCC) is a complex and heterogeneous disease that is affected by multiple genetic and epigenetic alterations [1]. In the overwhelming majority of patients, liver cirrhosis -another complex disease in its own right -is superimposed on HCC. As a result, the prognostic range for these patients varies considerably and continues to change for each patient at every time point over the clinical course of their disease. A meta-analysis of 30 clinical trials into which HCC patients were enrolled for palliative treatment reflects this heterogeneity. It demonstrated a high variability in survival among untreated patients and concluded that no single patient characteristic alone could predict outcome [2].The prognosis and treatment options for HCC are generally related to tumor stage and liver function at presentation [3,4]. In the west, approximately 30% of all patients with HCC are diagnosed in

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Appropriate Management of Cutaneous Adverse Events Maximizes Compliance with Sorafenib Treatment: A Single-Center Experience

Abstract: Our treatment approach seemed to reduce the incidence and/or severity of AEs, keeping patients in treatment, which is essential for good treatment outcomes.

Cited by 11 publications

References 20 publications

Pharmacotherapy follow-up of key points in the safety of oral antineoplastic agents

Pharmacotherapy follow-up of key points in the safety of oral antineoplastic agents

Management of adverse events associated with tyrosine kinase inhibitors: Improving outcomes for patients with hepatocellular carcinoma

Refining Sorafenib Therapy: Lessons from Clinical Practice

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