Toxicities of Targeted Therapy and Their Management in Kidney Cancer

Lorenzo, Giuseppe Di; Porta, Camillo; Bellmunt, Joaquim; Sternberg, Cora N.; Kirkali, Ziya; Staehler, Michael; Joniau, Steven; Montorsi, Francesco; Buonerba, Carlo

doi:10.1016/j.eururo.2011.01.002

Cited by 120 publications

(117 citation statements)

References 58 publications

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“…L'incidence est plus élevée avec le sunitinib et à un degré moindre avec le sorafénib [3,[9][10][11]. Elles sont globalement moins sévères qu'avec les inhibiteurs mTOR et justifient rarement l'arrêt du traitement.…”

Section: Mucites /Ulcérations Aphtoïdesunclassified

Toxicités orales des thérapies ciblées anticancéreuses

Sibaud

Vigarios

2015

Med Buccale Chir Buccale

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Résumé -Introduction :Les thérapies ciblées anticancéreuses ont profondément modifié la prise en charge du cancer et constituent aujourd'hui un des socles thérapeutiques majeurs en oncologie. Propos : Un certain nombre de récepteurs ou voies de signalisation ciblés par ces nouvelles thérapies sont également exprimés physiologiquement par les cellules épithéliales ou du chorion de la muqueuse buccale. De nombreuses thérapies ciblées (inhibiteur BRAF, anti-EGFR ou anti-MEK, inhibiteur BCR-ABL, anti-PD1/PDL-1, inhibiteurs mTOR, molécules antiangiogéniques…) peuvent donc induire des effets indésirables muqueux variés et jusque-là assez mal individualisés. Les principales toxicités orales qui peuvent être observées avec ces nouvelles thérapies ciblées anticancéreuses sont détaillées dans cet article. Conclusion : Le spécialiste en médecine et chirurgie buccales doit savoir les reconnaître et les prendre en charge.Abstract -Oral toxicity of targeted anticancer therapies. Introduction: Targeted anticancer therapies have greatly modified management of cancer patients and currently represent one of the cornerstones of cancer treatment. Purpose: A large number of receptors or signaling pathways targeted by these new drugs are also physiologically expressed in normal cells of the oral mucosa. Therefore, some targeted therapies (BRAF inhibitors, anti-EGFR, BCR-ABL inhibitors, anti-PD1/PDL-1, mTOR inhibitors, angiogenesis inhibitors, etc. ) may induce various mucosal manifestations hitherto poorly individualized. We detail here the most representative mucosal toxicity that can be observed with these new targeted anticancer therapies. Conclusion: Physicians specialized in oral medicine and oral surgery should be aware of these new mucosal adverse events.

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Section: Mucites /Ulcérations Aphtoïdesunclassified

Toxicités orales des thérapies ciblées anticancéreuses

Sibaud

Vigarios

2015

Med Buccale Chir Buccale

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“…Incidence of grade 3 or 4 hypertension in metaanalyses of trials conducted with VEGF inhibitor and TKIs was less than 10% in patients with mRCC (6.5% with sorafenib, 7.1% with bevacizumab and 8.3% with sunitinib) (Di Lorenzo et al, 2011). Antihypertensives are tailored to patient's characteristics, with consideration given to comorbidities, contraindications and other interactions.…”

Section: Cardiac Toxicitymentioning

confidence: 99%

“…In phase III trials, 15% and 11% of patients treated with everolimus and temsirolimus, respectively had grade 3-4 hyperglycemia (Di Lorenzo et al, 2011). While sulfonylureas and biguanides are contraindicated in renal dysfunction, glitazones and biguanides are avoided in patients with impaired liver function.…”

Section: Metabolic Toxicitymentioning

confidence: 99%

Practical Insights and Challenges in the Rational Use of Targeted Agents in Metastatic Clear Cell Renal Carcinoma

Andhavarapu¹,

Tan

2012

CCO

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Renal cell carcinoma (RCC) accounts for approximately 4% of all primary cancers diagnosed in the United States with an estimated 13,000 deaths in 2010. Metastatic disease is the initial presentation in approximately 30% of the patients. Until 2006, immunotherapy with Interferon-α and Interleukin-2 represented the primary treatment of advanced RCC but better understanding of the pathogenesis and molecular biology of RCC paved the way for targeted molecular therapies. Six molecular targeted agents have been approved for the treatment of metastatic renal cell carcinoma (mRCC). This review summarizes the approved targeted agents, their toxicities and practical insights into the treatment of mRCC.

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“…Although their mechanism of action is the same, they differ in the spectrum of targeted kinases, pharmacokinetics and specific adverse events [1]. TKIs have different toxicity than conventional chemotherapy agents [2]. The side effects are rarely life-threatening but may reduce quality of life [3].…”

mentioning

confidence: 99%

“…However, some distinct side effects require monitoring and treatment. The most common adverse events associated with SUN therapy are fatigue, diarrhoea, nausea, anorexia, hypertension, a yellow skin discoloration, hand-foot skin reaction, hypothyroidism, stomatitis, altered taste and constipation [2,14,15]. The side effects can be managed through supportive care, dose interruption or reduction.…”

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confidence: 99%

Role of Sunitinib-Induced Hypothyroidism in Oncological Patients

Baldelli¹

2017

EMIJ

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Sunitinb (SUN) belongs to a new class of multi targeted tyrosine kinase inhibitors (TKIs) used in treatment of metastatic renal cell carcinoma, gastrointestinal stromal tumors and pancreatic neuroendocrine tumors. Although generally well tolerated with favourable safety profile, SUN has distinct side effects that differ from the standard chemotherapy and require monitoring and management. Hypothyroidism is one of the most important adverse events induced by SUN. It is usually subclinical and rarely severe, with variable incidence. . The potential mechanisms involved in thyroid dysfunction are not fully understood. Generally, SUN-induced hypothyroidism does not require discontinuation of cancer therapy but only needs the thyroid replacement therapy. The occurrence of SUNinduced hypothyroidism appears with successful treatment in term of survival of oncological patients but more clinical investigations are necessary to validate this correlation.

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Toxicities of Targeted Therapy and Their Management in Kidney Cancer

Cited by 120 publications

References 58 publications

Toxicités orales des thérapies ciblées anticancéreuses

Toxicités orales des thérapies ciblées anticancéreuses

Practical Insights and Challenges in the Rational Use of Targeted Agents in Metastatic Clear Cell Renal Carcinoma

Role of Sunitinib-Induced Hypothyroidism in Oncological Patients

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