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Management of sorafenib, sunitinib, and temsirolimus toxicity in metastatic renal cell carcinoma

2009; Lippincott Williams & Wilkins; Volume: 3; Issue: 3 Linguagem: Inglês

10.1097/spc.0b013e32832e4681

1751-4266

Catherine Guevremont, Ahmed Alasker, Pierre I. Karakiewicz,

Chemotherapy-induced organ toxicity mitigation

Purpose of review To review the common and serious toxicities associated with the use of tyrosine kinase inhibitors such as sorafenib and sunitinib and mTOR inhibitor temsirolimus, and to outline the most recent toxicity management guidelines. Recent findings Common grade 3 or 4 side effects with sorafenib include lymphopenia (13%), hypophosphatemia (13%), elevated lipase (12%), hand–foot syndrome (6%), and mucositis/stomatitis (6%). Common grade 3 or 4 side effects with suntinib elevated lipase (16%), neutropenia (12%), lymphopenia (12%), hypertension (8%), and fatigue/asthenia (7%). As for temsirolimus, common grade 3 or 4 side effects consist of anemia (20%), hyperglycemia (11%), fatigue/asthenia (11%), dyspnea (9%), and hypophosphatemia (5%). Intracranial hemorrhage (ICH) is rare but occurred in sorafenib-exposed and sunitinb-exposed patients. Cardiovascular morbidity may also be observed in sorafenib-exposed and sunitinib-exposed patients. Summary Through preventive and therapeutic measures, these side effects can be effectively managed, without reducing the dose and, therefore, affecting the efficacy of the treatment.