Radiation-recall dermatitis with the everolimus/exemestane combination ten years after adjuvant whole-breast radiotherapy

Ioannidis, Georgios; Gkogkou, Pinelopi; Charalampous, Pandelitsa; Diamandi, Maria; Ioannou, Rena

doi:10.1016/j.radonc.2014.08.030

Cited by 11 publications

(3 citation statements)

References 8 publications

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“…Our case is special as vasculitis manifested itself in a previously irradiated skin. Similarly, Ioannidis et al reported a case of radiation recall vasculitis of CTCAE grade 2 after only 3 days of treatment with everolimus and exemestane in a mammary region irradiated 10 years ago [4]. They did not perform a biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Recall dermatitis disappeared after 2 weeks of discontinuation with everolimus and exemestane and therapy with steroids. On rechallenge of exemestane and lower dose of everolimus (5 mg), recall dermatitis did not recur [4]. Bourgier et al reported 'in-radiation-field' gastric mucocal inflammation and ulcers in a breast cancer patient, treated with paclitaxel, trastuzumab and everolimus.…”

Section: Discussionmentioning

confidence: 99%

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Leukocytoclastic Vasculitis Associated with Exemestane/Everolimus Therapy in a Previously Irradiated Skin: Case Report

Kuhar¹,

Geršak²,

StevanoviÄ³

et al. 2018

Br J Res

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Background: Leukocytoclastic vasculitis may be secondary to medications, underlying infection, collagen-vascular disorders, or malignancy. We report the second case of leukocytoclastic vasculitis related to exemestane/ everolimus therapy in breast cancer and present our review of literature.Case presentation: A 68-year-old Caucasian woman, treated with exemestane and everolimus for metastatic breast cancer presented with skin necrosis and allodynia in the right mammary region. A biopsy disclosed leukocytoclastic vasculitis. The patient received radiation therapy to the right breast due to exulcerated breast cancer (20 × 2.5 Gy, total dose 50 Gy) two and a half years ago. Skin necrosis appeared after five days of treatment with everolimus and 22 days of exemestane. The treatment with exemestane was continued, but everolimus was discontinued. Allodynia disappeared in two weeks after everolimus discontinuation. The skin healed very slowly and an eschar persisted for several months. The prompt resolution of allodynia, evident healing of skin necrosis after everolimus discontinuation, and high score in the Naranjo Adverse Drug Reaction Probability Scale strongly suggest the causative role of everolimus in leukocytoclastic vasculitis.A review of literature revealed only one case of leukocytoclastic vasculitis caused by everolimus and one case of radiation recall dermatitis caused by exemestane/ everolimus. Even though it is a serious adverse effect, it is usually reversible by drug discontinuation and symptomatic treatment only. Conclusion:Everolimus-related skin recall presented as leukocytoclastic vasculitis is a very rare adverse drug reaction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Leukocytoclastic Vasculitis Associated with Exemestane/Everolimus Therapy in a Previously Irradiated Skin: Case Report

Kuhar¹,

Geršak²,

StevanoviÄ³

et al. 2018

Br J Res

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“…Our patient's history definitively correlates letrozole with RRD and extends the known radiation-RRD gap for this drug to up-to nearly 10 years. Significantly, only four other cases of aromataseinhibitor-induced RRD have been reported, including one for letrozole in a patient with a recent (<3 month) history of radiation (Table 1) 6,[20][21][22] . Of note, in one of these cases, letrozole did not induce RRD while another aromatase inhibitor did.…”

Section: Discussionmentioning

confidence: 99%

Radiation recall dermatitis following letrozole administration in patient with a remote history of radiation therapy

et al. 2021

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We report the case of letrozole-induced radiation recall dermatitis (RRD) in a patient with a remote history of radiation therapy. There is only one previously known case of RRD triggered by letrozole in a patient with a recent (<3 month) history of radiation. Previously, only four other cases of aromatase-inhibitor-induced RRD have been reported. This case is significant for cancer care teams considering personalized treatments. In addition, improved long-term outcomes in cancer patients may lead to increases in and underdiagnoses of RRD. Likewise, RRD is patient specific, exacerbating health concerns, and can be difficult to recognize without proper awareness, documentation, and classification of triggering drugs. The authors hope to address these issues in this report.

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Dermatologic Adverse Effects of Anticancer Therapy III: Targeted and Immunotherapies

Dang

Thompson

Liu

et al. 2021

Dermato-Oncology Study Guide

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Radiation-recall dermatitis with the everolimus/exemestane combination ten years after adjuvant whole-breast radiotherapy

Cited by 11 publications

References 8 publications

Leukocytoclastic Vasculitis Associated with Exemestane/Everolimus Therapy in a Previously Irradiated Skin: Case Report

Leukocytoclastic Vasculitis Associated with Exemestane/Everolimus Therapy in a Previously Irradiated Skin: Case Report

Radiation recall dermatitis following letrozole administration in patient with a remote history of radiation therapy

Dermatologic Adverse Effects of Anticancer Therapy III: Targeted and Immunotherapies

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