Hyperglycemic-Inducing Neoadjuvant Agents Used in Treatment of Solid Tumors: A Review of the Literature

Hershey, Denise Soltow; Bryant, Ashley Leak; Olausson, Jill; Davis, Ellen D.; Brady, Veronica; Hammer, Marilyn J.

doi:10.1188/14.onf.e343-e354

Cited by 34 publications

(23 citation statements)

References 42 publications

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“…Finally, NETs patients are at risk for the development of hyperglycaemia from second-line treatments, including interferon-α (IFN-α) and certain chemotherapeutic agents [42]. It is well-know that IFN-α may induce autoimmune type 1 DM and may result in permanent insulin therapy dependency [9].…”

Section: Drug Therapymentioning

confidence: 99%

Diabetes and pancreatic neuroendocrine tumours: Which interplays, if any?

Gallo

Ruggeri

Muscogiuri³

et al. 2018

Cancer Treatment Reviews

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Pancreatic neuroendocrine tumours (PanNETs) represent an uncommon type of pancreatic neoplasm, whose incidence is increasing worldwide. As per exocrine pancreatic cancer, a relationship seems to exist between PanNETs and glycaemic alterations. Diabetes mellitus (DM) or impaired glucose tolerance often occurs in PanNET patients as a consequence of hormonal hypersecretion by the tumour, specifically affecting glucose metabolism, or due to tumour mass effects. On the other hand, pre-existing DM may represent a risk factor for developing PanNETs and is likely to worsen the prognosis of such patients. Moreover, the surgical and/or pharmacological treatment of the tumour itself may impair glucose tolerance, as well as antidiabetic therapies may impact tumour behaviour and patients outcome. Differently from exocrine pancreatic tumours, few data are available for PanNETs as yet on this issue. In the present review, the bidirectional association between glycaemic disorders and PanNETs has been extensively examined, since the co-existence of both diseases in the same individual represents a further challenge for the clinical management of PanNETs.

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Section: Drug Therapymentioning

confidence: 99%

Diabetes and pancreatic neuroendocrine tumours: Which interplays, if any?

Gallo

Ruggeri

Muscogiuri³

et al. 2018

Cancer Treatment Reviews

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“…[123] Patients with diabetes and cancer who are receiving chemotherapy are at an increased risk for developing glycemic issues. [456] The relationship between chemotherapy and glycemic control is not completely understood. The purpose of this study was to explore the impact chemotherapy that had on glycemic control over a 12-week period in adults with Type 2 diabetes (T2D) and solid tumor or lymphoma cancer.…”

Section: Introductionmentioning

confidence: 99%

“…[7] Many chemotherapy agents have been linked to the development of hyperglycemia in patients without diabetes. [4] The combination of chemotherapy and corticosteroids that are commonly used during cancer treatment puts the patient at risk for developing hyperglycemia, which is a clinical toxicity that can have an impact on chemotherapy dose reductions, interruptions, or stoppages. [78] Poor glycemic control in cancer patients is associated with a more clinically aggressive cancer course and development of adverse events such as neutropenia, infections, and mortality.…”

Section: Introductionmentioning

confidence: 99%

Chemotherapy and glycemic control in patients with type 2 diabetes and cancer: A comparative case analysis

Hershey

Hession

2017

Asia-Pacific Journal of Oncology Nursing

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Objective:Individuals with diabetes who develop cancer have a worse 5-year overall survival rate and are more likely to develop an infection and/or be hospitalized when compared to those without diabetes. Patients with diabetes and cancer receiving chemotherapy have an increased risk for developing glycemic issues. The relationship between chemotherapy and glycemic control is not completely understood. The aim of this study was to explore the relationship between glycemic control, symptoms, physical and mental function, development of adverse events, and chemotherapy reductions or stoppages in adults with Type 2 diabetes (T2D) and cancer.Methods:A prospective 12-week longitudinal cohort study recruited 24 adults with T2D, solid tumor cancer, or lymphoma receiving outpatient intravenous chemotherapy. Eighteen individuals completed baseline data and were included in the analysis. A comparative case analysis was performed to analyze the results.Results:Potential predictors of occurrence of an adverse event include sex (relative risk [RR] = 1.5), treatment with insulin (RR = 2.17), years with diabetes (RR = 3.85), and baseline glycated hemoglobin (HbA1c) (odds ratio [OR] = 1.67). Baseline body mass index (BMI) (OR = 1.16) and HbA1c (OR = 1.61) were potentially predictive of a chemotherapy stoppage.Conclusions:Level of glycemic control at the time an individual begins treatment for cancer appears to contribute to the occurrence of an adverse event, developing an infection and/or being hospitalized during treatment, and the increased risk of having a chemotherapy reduction or stoppage. Clinicians working with patients receiving chemotherapy for a solid tumor cancer who have pre-existing diabetes, need to be aware of how the patients glycemic level at the start of treatment may impact successful treatment completion.

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“…However, people with cancer experience unique challenges to glycemic homeostasis as a consequence of cancer and its treatment (Hammer et al, 2016). Factors contributing to hyperglycemia in people with cancer include: physiologic stress, glycemic status (glucose intolerant, diagnosis of diabetes, pre or unknown diagnosis of diabetes), the administration of glucocorticoids, and changes in nutrition and activity (Dungan, Braithwaite, & Preiser, 2009; Harris et al, 2013; Hershey et al, 2014). An additional challenge is the receipt of frequent blood transfusions to address disease/treatment related anemia which precludes the use of Hemoglobin A 1c (HbA1 c ), the blood test recommended for diagnosing diabetes and monitoring blood glucose (Farrokhi, Smiley & Umpierrez, 2011) (Shrot, Patel, & Foulis, 2007).…”

mentioning

confidence: 99%