Reversible Posterior Encephalopathy Syndrome Secondary to Sunitinib

Costa, Ricardo; Costa, R.M.M; Brito, Gilberto Moura de; Cartaxo, Henrique Q.; Barros, Alex Caetano de

doi:10.1155/2014/952624

Cited by 17 publications

(6 citation statements)

References 16 publications

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“…Similarly, the cause of weakness, ataxia and fine head tremors could be related to toceranib, use of phenobarbitone or GIST. A syndrome of reversible posterior leukoencephalopathy has been reported after sunitinib treatment; usually early in the course of treatment, but was seen after 8 months of therapy in a least one human patient . This does emphasize the point that many rare toxicities of TKIs have now been described (often thought to be due to inhibition of vascular endothelial growth factor), and a more appropriate approach to unexpected syndromes in patients on TKIs may be to institute a ‘drug holiday’; in hindsight that should have been prescribed in our patient when neurologic signs were reported and when weight loss was documented.…”

Section: Discussionmentioning

confidence: 68%

Management of a feline gastric stromal cell tumour with toceranib phosphate: a case study

McGregor¹,

Moore²,

Yeomans³

2020

Aust Veterinary J

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Background A fifteen‐year old, female spayed domestic longhaired cat was presented for a routine vaccination during which an incidental abdominal mass was palpated. After further inquiry, occasional vomiting was reported to occur once every few weeks to months, associated with no other gastrointestinal signs. Case report Ultrasonography revealed a gastric mass. Histopathology and immunohistochemistry confirmed a CD117 positive, smooth muscle actin and desmin negative neoplasm, consistent with a gastrointestinal stromal cell tumour (GIST). Treatment was initiated with toceranib phosphate resulting in stable disease for over eighteen months, and the patient was still alive at the time of writing. Conclusion GISTs are rare in cats and this is the first report of medical management of feline GIST using toceranib.

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Section: Discussionmentioning

confidence: 68%

Management of a feline gastric stromal cell tumour with toceranib phosphate: a case study

McGregor¹,

Moore²,

Yeomans³

2020

Aust Veterinary J

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“…All of these VEGF receptor antagonists can potentially cause RPLS. While cases of RPLS due to renal carcinoma targeted therapies are rare, reports involving sunitinib have been most frequent [5][6][7][8][9][10][11][12][13]. We report herein the second case, to our knowledge with RPLS induced by axitinib [13].…”

Section: Discussionmentioning

confidence: 80%

Axitinib-induced reversible posterior leukoencephalopathy syndrome in a patient with metastatic renal cell carcinoma

et al. 2017

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A 61-year-old woman with metastatic renal carcinoma was treated with axitinib as a second-line tyrosine kinase inhibitor. Thirteen days after the treatment, the patient developed reversible posterior leukoencephalopathy syndrome (RPLS). Her symptoms and imaging findings resolved after withdrawal of axitinib, blood pressure control, and administration of glycerin and levetiracetam. RPLS should be kept in mind as a possible rare adverse event after axitinib administration.

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“…When quickly recognized and managed, the symptoms and the radiological alterations usually are almost always reversible with complete or near-complete resolution lasting from several days to months. Nonetheless, a delay in diagnosis and intervention, with adequate blood pressure control and the discontinuation of the responsible drug, may cause irreversible neurological damage and death by cerebral ischemia or hemorrhage [23]. It is not clear if there is a correlation between response to TKI and incidence of PRES, even though anti-VEGFR therapy-induced hypertension, which is the main cause of PRES, is associated with improved clinical outcomes with antiangiogenetic agents [24,25].…”

Section: Discussionmentioning

confidence: 99%

Rare anti-VEGFR therapy-induced toxicity and long-term response to immunotherapy in a rare non-clear cell renal cell carcinoma patient

Catalano¹,

Rebuzzi²,

Murianni³

et al. 2021

Anti-Cancer Drugs

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Advanced non-clear cell renal cell carcinoma (nccRCC) has a poor prognosis and clinical data on the therapeutic options currently available, including immunotherapy, are generally limited highlighting an unmet clinical need. Moreover, the onset of rare adverse events raises the need of a better therapeutic management of limited treatment options. We report the clinical case of a 63-yearold man with the diagnosis of metastatic mucinous tubular and spindle cell carcinoma, a rare nccRCC, with sarcomatoid differentiation who developed two episodes of posterior reversible encephalopathy syndrome (PRES) to first-line sunitinib. It appeared after 5 months the start of the targeted therapy and reappeared at the reintroduction of the therapy. PRES is a rare and unusual adverse event to anti-vascular endothelial growth factor receptor (VEGFR) therapies, which is characterized by acute neurological disorders along with typical changes on neurological imaging, especially MRI. Moreover, this rare histotype of RCC experienced a long-term response to immunotherapy which is lasting more than 2 years. This clinical case is interesting for its rarity as a rare neurological adverse event developed twice in a rare type of RCC which also experienced an unusual longterm benefit to immunotherapy. Anti-Cancer Drugs 33: e724-e729

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Reversible Posterior Encephalopathy Syndrome Secondary to Sunitinib

Cited by 17 publications

References 16 publications

Management of a feline gastric stromal cell tumour with toceranib phosphate: a case study

Management of a feline gastric stromal cell tumour with toceranib phosphate: a case study

Axitinib-induced reversible posterior leukoencephalopathy syndrome in a patient with metastatic renal cell carcinoma

Rare anti-VEGFR therapy-induced toxicity and long-term response to immunotherapy in a rare non-clear cell renal cell carcinoma patient

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