Good local tumor control but lethal hemorrhage after apatinib treatment for intractable squamous carcinoma of the floor of the mouth: a case report

Zhu, Xiaodong; Liu, Min; Lv, Jincai; Guo, Liang; Li, Cheng; Dong, Lihua; Liu, Bailong

doi:10.2147/ott.s180358

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…VEGFR inhibitor antitumor drugs have the potential to increase the risk of bleeding. In phase III clinical studies, the observed bleeding symptoms included gastrointestinal bleeding, hematemesis, hemoptysis, fecal occult blood, urinary occult blood, skin bleeding, and hemorrhagic rupture of liver metastases and a common serious adverse reaction was upper gastrointestinal bleeding [64,65]. The bleeding should be closely monitored when using the drug.…”

Section: Adverse Effects and Managementmentioning

confidence: 99%

Adverse events and management of apatinib in patients with advanced or metastatic cancers: A review

Shao

Zhang

Yang

et al. 2020

neo

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Apatinib (YN968D1) is a novel and highly selective tyrosine kinase inhibitor that inhibits vascular endothelial growth factor receptor-2 (VEGFR-2) and is approved as a third-line and subsequent-line treatment for advanced gastric adenocarcinoma or gastroesophageal junction adenocarcinoma in China. Apatinib is also widely studied in other solid tumors. With the increase in clinical research of apatinib, its adverse effects have also received widespread attention. Hence, this article summarizes the pharmacological properties of apatinib and reviews its clinical use in advanced or metastatic cancers. We highlight the common adverse reactions of apatinib in clinical applications and we also clarify the corresponding prevention and intervention measures. Overall, this review will help us better understand the safety and efficacy of apatinib treatment.

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Section: Adverse Effects and Managementmentioning

confidence: 99%

Adverse events and management of apatinib in patients with advanced or metastatic cancers: A review

Shao

Zhang

Yang

et al. 2020

neo

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“…3) Special attention should be paid to the possibility of massive bleeding caused by tumor erosion and necrosis. Physicians should focus on choosing suitable candidates, detailed assessment, close surveillance, and active management to minimize lethal cancer-related complications besides yielding ideal tumor control [ 75 ]. 4) Physicians should use drugs according to the indications of the drugs.…”

Section: Discussionmentioning

confidence: 99%

Analysis of medical malpractice liability disputes related to novel antineoplastic drugs and research on risk prevention and control strategies

Luo

Zheng

2023

PLoS ONE

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Objective To investigate the general characteristics of litigation cases of medical malpractice liability disputes (MMLDs) related to novel antineoplastic drugs (NADs), the drugs involved, as well as the common types of medical errors related to NADs and their damages in the process of diagnosis and treatment, with the aims of improving the level of rational medication use in the clinical application of NADs and actively prevent medical disputes. Methods The China Judgments Online was searched for the cause of action using the key word “MMLDs” along with the name of 77 kinds of NADs. A total of 39 NAD litigation cases meeting the inclusion criteria from 1 January 2009 to 31 December 2021 were analyzed, and each potential adverse drug reaction (ADR) was reviewed to determine a causality assessment using the Naranjo algorithm for non-drug-induced liver injury (DILI) cases and the updated Roussel Uclaf Causality Assessment Method (RUCAM) for the DILI cases. Risk prevention and control strategies were recommended. Results Cases that met the inclusion criteria increased substantially each year during the last six years, from three cases in 2009–2015 to 36 cases in 2016–2021. There were more cases in Eastern China than in other geographic regions. Most cases involved tertiary hospitals, patients between 25 and 60 years of age, and patients who were predominately male. There were 18 kinds of NADs involved in medical errors. The most common consequences of NADs were closely related to the death, disability, and increased treatment costs caused by ADRs, inadequate indications, delayed diagnosis and treatment, and misdiagnosis and mistreatment. The most frequent medical errors were medical technology errors, medical ethics errors and medical record writing/safekeeping errors. In two cases involving DILI, one case was unable to undergo further RUCAM scoring because the liver function indicators of the patient before and after treatment were not published. Conclusion The establishment of mechanisms to reduce the risks associated with the clinical application of NADs is warranted. Healthcare services must maintain strict adherence to the specific requirements of GPCANADs and drug instructions and strictly grasp the indications, contraindications, usage, and dosage of drugs, and strengthen the notification and management of off-label drug use. Monitoring patients for ADRs and preparing rescue and treatment measures for high-risk drugs may serve to reduce damages related to NADs. For DILI cases, medical and appraisal institutions should use RUCAM score to assess causal relationships.

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“…Therefore, the tumor tissue could not be supplied with enough oxygen and nutrients for continuous proliferation, thereby causing tumor necrosis and shrinkage. Zhu et al [ 16 ] reported that apatinib enhances the risk of fatal hemorrhage. This is because during growth, the tumor invades blood vessels, and after apatinib administration, the tumor shrinks, thereby causing bleeding.…”

Section: Discussionmentioning

confidence: 99%

Rapid response of locally advanced oral squamous cell carcinoma to apatinib: A case report

Zhang

Gao

et al. 2021

Open Medicine

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There are no effective therapeutic options for locally advanced head and neck squamous cell carcinoma (HNSCC). Additionally, there is no standard therapy for patients subjected to multiple lines of treatment. Angiogenesis plays a key role in tumor growth and metastasis. Therefore, inhibition of tumor angiogenesis is an important strategy for tumor therapy. Apatinib is a novel tyrosine kinase inhibitor that inhibits angiogenesis by targeting vascular endothelial growth factor receptor-2 (VEGFR-2). The effect of apatinib on HNSCC has not been clearly established. In this study, we administered apatinib in combination with anti-epidermal growth factor receptor (EGFR) targeted and systemic chemotherapy for the treatment of oral cancer and to achieve better disease outcomes. To avoid fatal bleeding, after achieving good clinical outcomes, the follow-up treatment plan was adjusted. The efficacy of apatinib combined with anti-EGFR targeted and systemic chemotherapy for the treatment of oral cancer has not been previously reported. Our findings show the therapeutic potential of apatinib for advanced HNSCC patients with multiple lines of chemotherapy, especially for patients with large neck masses.

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Good local tumor control but lethal hemorrhage after apatinib treatment for intractable squamous carcinoma of the floor of the mouth: a case report

Cited by 6 publications

References 19 publications

Adverse events and management of apatinib in patients with advanced or metastatic cancers: A review

Adverse events and management of apatinib in patients with advanced or metastatic cancers: A review

Analysis of medical malpractice liability disputes related to novel antineoplastic drugs and research on risk prevention and control strategies

Rapid response of locally advanced oral squamous cell carcinoma to apatinib: A case report

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