Incidence and management of mtor inhibitor-associated pneumonitis in patients with metastatic renal cell carcinoma Journal Article
| Authors: | Albiges, L.; Chamming's, F.; Duclos, B.; Stern, M.; Motzer, R. J.; Ravaud, A.; Camus, P. |
| Article Title: | Incidence and management of mtor inhibitor-associated pneumonitis in patients with metastatic renal cell carcinoma |
| Abstract: | The administration of mammalian target of rapamycin (mTOR) inhibitors can give rise to a potentially life-threatening adverse event, often referred to as 'non-infectious pneumonitis' (NIP), which is characterized by non-infectious, non-malignant, and non-specific inflammatory infiltrates. Patients usually present with cough and/or dyspnoea. We provide a brief description of the mechanism of action of mTOR inhibitors and their overall safety in patients with metastatic renal cell carcinoma (mRCC) and review the literature on mTOR inhibitor-associated NIP in patients with solid tumours. The review was used to derive questions on the diagnosis, management, and monitoring of mRCC patients with NIP, and to develop a decision tree for use in routine clinical practise. A key recommendation was the subdivision of grade 2 NIP into grades 2a and 2b, where grade 2a is closer to grade 1 and grade 2b to grade 3. This subdivision is important because it takes into account the nature and severity of clinical symptoms potentially related to NIP, either the onset of new symptoms or the worsening of existing symptoms, and thus determines the type and frequency of follow-up. It also helps to identify a subgroup of patients in whom treatment, if effective, may be continued without dose adjustment. © The Author 2012. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. |
| Keywords: | osteosarcoma; vasculotropin; overall survival; drug tolerability; fatigue; pathogenesis; review; placebo; advanced cancer; diarrhea; disease classification; drug dose comparison; drug dose reduction; drug efficacy; drug safety; drug withdrawal; recommended drug dose; side effect; solid tumor; alpha interferon; anorexia; progression free survival; drug eruption; mantle cell lymphoma; breast cancer; anemia; lung non small cell cancer; mucosa inflammation; nausea; stomatitis; thrombocytopenia; differential diagnosis; incidence; renal cell carcinoma; kidney carcinoma; kidney neoplasms; hodgkin disease; temsirolimus; abdominal pain; asthenia; coughing; drug fever; dyspnea; hyperglycemia; neuroendocrine tumor; pneumonia; protein kinase inhibitors; chemotherapy induced emesis; drug induced headache; prednisolone; disease severity; drug mechanism; carcinoma, renal cell; dosage schedule comparison; mammalian target of rapamycin; phosphatidylinositol 3,4,5 trisphosphate 3 phosphatase; lymphoma; neoplasm metastasis; peripheral edema; soft tissue sarcoma; recurrent disease; stomach cancer; carcinoid; interstitial lung disease; methylprednisolone; thorax radiography; graft rejection; hypercholesterolemia; mammalian target of rapamycin inhibitor; antibiotics, antineoplastic; breast metastasis; lung function test; kidney metastasis; everolimus; rapamycin; lung infiltrate; tuberous sclerosis; hypertriglyceridemia; lung lavage; high resolution computer tomography; mammalian target of rapamycin complex 1; organ transplantation; noninfectious pneumonitis; pancreatic neuroendocrine tumor; tor serine-threonine kinases; ridaforolimus; mammalian target of rapamycin complex 2; pulmonary toxicity; cancer prognosis; solid tumour; stomach metastasis |
| Journal Title: | Annals of Oncology |
| Volume: | 23 |
| Issue: | 8 |
| ISSN: | 0923-7534 |
| Publisher: | Oxford University Press |
| Date Published: | 2012-08-01 |
| Start Page: | 1943 |
| End Page: | 1953 |
| Language: | English |
| DOI: | 10.1093/annonc/mds115 |
| PROVIDER: | scopus |
| PUBMED: | 22689175 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 4 September 2012" - "Art. No.: mds115" - "CODEN: ANONE" - "Source: Scopus" |
