1
|
Evaluation of Delayed-Type Hypersensitivity to Antineoplastic Drugs-An Overview. Cancers (Basel) 2023; 15:cancers15041208. [PMID: 36831549 PMCID: PMC9954236 DOI: 10.3390/cancers15041208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/30/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
Nowadays, clinical practice encounters the problem of delayed-type hypersensitivity (DTH) induced by several drugs. Antineoplastic treatments are among the drugs which show an elevated proportion of DHT reactions, leading to the worsening of patients' quality of life. The range of symptoms in DHT reactions can vary from mild, such as self-limiting maculopapular eruptions, to severe, such as Stevens-Johnson Syndrome. The development of these reactions supposes a negative impact, not only by limiting patients' quality of life, but also leading to economic loss due to market withdrawal of the affected drugs and high hospitalization costs. However, despite this problem, there are no available standard in vitro or in vivo methods that allow for the evaluation of the sensitizing potential of drugs in the preclinical phase. Therefore, the aim of this review is to summarize the skin reactions caused by the different antineoplastic families, followed by a comprehensive evaluation of the in vitro and in vivo methods used to detect DTHs and that could be suitable to test antineoplastic hypersensitivity reactions.
Collapse
|
2
|
Roger I, Montero P, García A, Milara J, Ribera P, Pérez-Fidalgo JA, Cortijo J. Evaluation of Antineoplastic Delayed-Type Hypersensitivity Skin Reactions In Vitro. Pharmaceuticals (Basel) 2022; 15:ph15091111. [PMID: 36145332 PMCID: PMC9501359 DOI: 10.3390/ph15091111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/22/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022] Open
Abstract
Delayed-type hypersensitivity (DTH) is caused by a broad number of drugs used in clinic, and antineoplastic drugs show an elevated proportion of DTH, which potentially affects the quality of life of patients. Despite the serious problem and the negative economic impact deriving from market withdrawal of such drugs and high hospitalization costs, nowadays, there are no standard validated methods in vitro or in vivo to evaluate the sensitizing potential of drugs in the preclinical phase. Enhanced predictions in preclinical safety evaluations are really important, and for that reason, the aim of our work is to adapt in vitro DPRA, ARE-Nrf2 luciferase KeratinoSensTM, and hCLAT assays for the study of the sensitizing potential of antineoplastic agents grouped by mechanism of action. Our results reveal that the above tests are in vitro techniques able to predict the sensitizing potential of the tested antineoplastics. Moreover, this is the first time that the inhibition of the VEGFR1 pathway has been identified as a potential trigger of DTH.
Collapse
Affiliation(s)
- Inés Roger
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Health Institute Carlos III, 28029 Madrid, Spain
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
- Correspondence: (I.R.); (P.M.); Tel.: +34-963864631 (I.R.)
| | - Paula Montero
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
- Correspondence: (I.R.); (P.M.); Tel.: +34-963864631 (I.R.)
| | - Antonio García
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
- Pharmacy Unit, University Clinic Hospital, 46010 Valencia, Spain
| | - Javier Milara
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Health Institute Carlos III, 28029 Madrid, Spain
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
- Pharmacy Unit, University General Hospital Consortium, 46014 Valencia, Spain
| | - Pilar Ribera
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Jose Alejandro Pérez-Fidalgo
- Department of Medical Oncology, University Clinic Hospital of Valencia, 46010 Valencia, Spain
- Biomedical Research Networking Centre on Cancer (CIBERONC), Health Institute Carlos III, 28029 Madrid, Spain
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
| | - Julio Cortijo
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Health Institute Carlos III, 28029 Madrid, Spain
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
- Research and Teaching Unit, University General Hospital Consortium, 46014 Valencia, Spain
| |
Collapse
|
3
|
Docetaxel-Induced Stevens-Johnson Syndrome in a Patient with Metastatic Prostate Adenocarcinoma. Case Rep Oncol Med 2019; 2019:7928752. [PMID: 30729055 PMCID: PMC6341237 DOI: 10.1155/2019/7928752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 12/09/2018] [Indexed: 01/25/2023] Open
Abstract
Docetaxel is a commonly used chemotherapeutic agent in a variety of cancer treatment regimens. We present a case of apparent docetaxel-induced Stevens-Johnson syndrome (SJS) in a patient recently treated for metastatic prostate cancer. This medication is not classically associated with the development of SJS but in our case, along with a number of other case reports, and a single phase II clinical trial, an association was recognized. We encourage clinicians who employ the use of this medication to be aware of this relationship.
Collapse
|
4
|
Salas-Martínez AM, Caballero CI, González-Vela MC, Mira MC, Laso-Dosal F, Val-Bernal JF. Paclitaxel-induced cutaneous change mimicking malignancy in a previous cutaneous eruption. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2018; 51:188-192. [PMID: 30012313 DOI: 10.1016/j.patol.2018.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/17/2018] [Accepted: 04/23/2018] [Indexed: 11/25/2022]
Abstract
Taxanes are antineoplastic drugs that can cause dermatotoxicity which can mimic an intraepidermal carcinoma. A 65-year-old woman presented with a cutaneous eruption suggestive of a paraneoplastic syndrome. Imaging studies showed multiple peritoneal nodules and associated ascites. A sample taken from the greater omentum revealed an adenocarcinoma. Clinical data and family history pointed to a gynecological origin of the tumor and the patient was treated with carboplatin and paclitaxel. A new cutaneous biopsy showed that the epidermis was acanthotic with atypical keratinocytes, abundant mitoses, and apoptotic figures, arising concerns of malignancy. According to the Plummer and Shea criteria, the lesion was ultimately interpreted as reactive cutaneous hyperplasia and expression of the taxane effect. We report, for the first time, paclitaxel-induced histologic changes on a previous cutaneous eruption. Pathologists should be aware of the profound cytopathic effects of taxane therapy in order to interpret skin biopsies of patients undergoing this treatment.
Collapse
Affiliation(s)
| | - Clara I Caballero
- Service of Anatomical Pathology, Sierrallana Hospital, Torrelavega, Spain
| | - M Carmen González-Vela
- Service of Anatomical Pathology, Marques de Valdecilla University Hospital, Medical Faculty, University of Cantabria and IDIVAL Research Institute, Santander, Spain
| | | | | | - José-Fernando Val-Bernal
- Pathology Unit, Medical and Surgical Sciences Department, University of Cantabria and IDIVAL Research Institute, Santander, Spain.
| |
Collapse
|
5
|
Fakoya AOJ, Omenyi P, Anthony P, Anthony F, Etti P, Otohinoyi DA, Olunu E. Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis; Extensive Review of Reports of Drug-Induced Etiologies, and Possible Therapeutic Modalities. Open Access Maced J Med Sci 2018; 6:730-738. [PMID: 29731949 PMCID: PMC5927512 DOI: 10.3889/oamjms.2018.148] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/21/2018] [Accepted: 02/28/2018] [Indexed: 12/19/2022] Open
Abstract
Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis are adverse hypersensitivity reactions that affect the skin and mucous membranes. They are characterised by erythematous macules and hemorrhagic erosions of the mucous membranes. Epidermal detachments of varying degrees of severity also occur in these conditions. Various aetiologies are associated with these conditions, with adverse drug reaction being the most common. Though the worldwide incidence of these conditions is recorded as low, diverse types of medication are being observed to lead to these conditions. This review compiles information on the details of Stevens-Johnson syndrome and Toxic Epidermal Necrolysis, the pathophysiology, therapeutic management, and largely considers the drug-induced etiologies associated with these conditions.
Collapse
Affiliation(s)
| | | | | | - Favour Anthony
- All Saints University, School of Medicine, Roseau, Dominica
| | - Precious Etti
- All Saints University, School of Medicine, Roseau, Dominica
| | | | - Esther Olunu
- All Saints University, School of Medicine, Roseau, Dominica
| |
Collapse
|
6
|
J Pelletier D, O'Donnell M, Stone MS, Liu V. Intravesicular taxane-induced dermatotoxicity in a 78-year-old man with urothelial carcinoma and primary cutaneous anaplastic large cell lymphoma. J Cutan Pathol 2018; 45:453-457. [PMID: 29484689 DOI: 10.1111/cup.13138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/19/2018] [Accepted: 02/22/2018] [Indexed: 11/30/2022]
Abstract
Patients treated with intravesical bacillus Calmette-Guérin therapy for urothelial carcinoma often become refractory and experience recurrent disease, thus necessitating alternative intravesical treatment modalities if the patient is to be spared the morbidities associated with radical cystectomy. Intravesical treatment with taxane-based chemotherapy, such as docetaxel, has gained traction in urologic oncology, proving to be an effective salvage therapy in such patients. Systemic taxane-based chemotherapeutic regimens have long been used in several advanced malignancies, and their systemic side-effects and associated histologic correlates have been extensively documented. In contrast to adverse effects associated with systemic administration, intravesical taxane administration has thus far proven to be well-tolerated, with little to no systemic absorption. To our knowledge, features of taxane-induced systemic effects have not been reported in this setting. Herein, we report a case of a patient with recurrent urothelial carcinoma treated with intravesical docetaxel, along with primary cutaneous anaplastic large cell lymphoma, who developed characteristic dermatotoxic histologic findings associated with intravenous taxane administration. As such histopathologic findings often represent close mimickers of neoplastic and infectious etiologies, knowledge of the potential for systemic manifestations of taxane therapy in patients treated topically may prevent potentially costly diagnostic pitfalls.
Collapse
Affiliation(s)
- Daniel J Pelletier
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Michael O'Donnell
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Mary Seabury Stone
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.,Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Vincent Liu
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.,Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| |
Collapse
|
7
|
Anticancer Drugs Induced Severe Adverse Cutaneous Drug Reactions: An Updated Review on the Risks Associated with Anticancer Targeted Therapy or Immunotherapies. J Immunol Res 2018; 2018:5376476. [PMID: 29577050 PMCID: PMC5822766 DOI: 10.1155/2018/5376476] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 11/07/2017] [Accepted: 11/08/2017] [Indexed: 12/29/2022] Open
Abstract
Cutaneous adverse drug reactions are commonly seen in patients with anticancer drug treatment. Anticancer drugs, including chemotherapy, target therapy, and recent immunotherapy causing skin reactions ranging from mild skin rash to life-threatening severe cutaneous adverse reactions (SCARs), such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) with increase morbidity and mortality while they are receiving cancer treatments, have been proposed to be a result of direct skin toxicity or drug hypersensitivity reactions (these are proposed mechanism, not definite). Differentiating SCARs from other more commonly seen reactions with a better outcome help prevent discontinuation of therapy and inappropriate use of systemic immunosuppressants for presumable allergic reactions, of which will affect the clinical outcome. In this article, we have reviewed published articles from 1950 to August 2017 for SJS/TEN associated with anticancer drugs, including chemotherapy, targeted therapy, and immunotherapy. We aimed to provide an overview of SJS/TEN associated with anticancer drugs to increase clinician recognition and accelerate future studies on the pathomechanism and managements.
Collapse
|
8
|
|
9
|
Abstract
Taxanes (docetaxel and paclitaxel) are among the most commonly prescribed anticancer drugs approved for the treatment of metastatic or locally advanced breast, non-small cell lung, prostate, gastric, head and neck, and ovarian cancers, as well as in the adjuvant setting for operable node-positive breast cancers. Although the true incidence of dermatological adverse events (AEs) in patients receiving taxanes is not known, and has never been prospectively analysed, they clearly represent one of the major AEs associated with these agents. With an increase in the occurrence of cutaneous AEs during treatment with novel targeted and immunological therapies when used in combination with taxanes, a thorough understanding of reactions attributable to this class is imperative. Moreover, identification and management of dermatological AEs is critical for maintaining the quality of life in cancer patients and for minimizing dose modifications of their antineoplastic regimen. This analysis represents a systematic review of the dermatological conditions reported with the use of these drugs, complemented by experience at comprehensive cancer centres. The conditions reported herein include skin, hair, and nail toxicities. Lastly, we describe the dermatological data available for the new, recently FDA-and EMA- approved, solvent-free nab-paclitaxel.
Collapse
|
10
|
Jarrett B, Ghazala S, Chao J, Chaudhary S. Case of Steven-Johnson Syndrome in a male with breast cancer secondary to docetaxel/cyclophosphamide therapy. BMJ Case Rep 2016; 2016:bcr-2016-217255. [PMID: 27852659 DOI: 10.1136/bcr-2016-217255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The mortality rate for Stevens-Johnson syndrome (SJS) is estimated to be ∼12% and for toxic epidermal necrolysis (TEN) it is around 30%. It continues to be a severe life-threatening drug reaction. We present a 60-year-old Caucasian man with a medical history significant for breast cancer status post mastectomy and chemotherapy with docetaxel and cyclophosphamide who presented with severe mucositis and a progressing skin rash consistent with SJS. He was started on high-dose corticosteroids and IVIG but continued to have worsening mucosal ulcerations and severe bleeding from the oral, conjunctival and genital mucosa. He underwent several rounds of plasmapheresis and additional high-dose steroids with mild improvement in the mucocutaneous manifestations. He subsequently developed respiratory failure, which required mechanical ventilation, as well as disseminated intravascular coagulation, diffuse alveolar haemorrhage, with Pneumocystis jirovecii pneumonia which led to his demise on hospital day 15.
Collapse
Affiliation(s)
- Benjamin Jarrett
- Department of Internal Medicine, University of Arizona, Tucson, Arizona, USA
| | - Sehem Ghazala
- Department of Internal Medicine, University of Arizona, Tucson, Arizona, USA
| | - Joseph Chao
- Department of Dermatology, University of Arizona, Tucson, Arizona, USA
| | - Sachin Chaudhary
- Department of Pulmonary and Critical Care, University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
11
|
Prieto-Torres L, Llamas-Velasco M, Machan S, Haro R, de Asis S, Carmo M, Loredo A, del Puerto C, Fried I, Kempf W, Cerroni L, Requena L. Taxanes-induced cutaneous eruption: another histopathologic mimicker of malignancy. J Eur Acad Dermatol Venereol 2015; 30:638-44. [DOI: 10.1111/jdv.13475] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 09/15/2015] [Indexed: 12/15/2022]
Affiliation(s)
- L. Prieto-Torres
- Department of Dermatology; Hospital Clínico Universitario Lozano Blesa; Zaragoza Spain
| | - M. Llamas-Velasco
- Department of Dermatology; Hospital Universitario de la Princesa; Universidad Autónoma; Madrid Spain
| | - S. Machan
- Department of Dermatology; Fundación Jiménez Díaz; Universidad Autónoma; Madrid Spain
| | - R. Haro
- Department of Dermatology; Fundación Jiménez Díaz; Universidad Autónoma; Madrid Spain
| | - S. de Asis
- Department of Dermatology; Hospital Universitario Doctor Peset; Valencia Spain
| | - M. Carmo
- Department of Pathology; Instituto Português de Oncología de Lisboa Francisco Gentil; Lisboa Portugal
| | - A. Loredo
- Department of Pathology; CMN 20 de Noviembre-ISSSTE; Ciudad de México Mexico
| | - C. del Puerto
- Department of Dermatology; Facultad de Medicina; Pontificia Universidad Católica de Chile; Santiago Chile
| | - I. Fried
- Dermatopathology Research Unit; Medical University of Graz; Graz Austria
| | - W. Kempf
- Kempf und Pfaltz Histologische Diagnostik; Zürich Switzerland
| | - L. Cerroni
- Dermatopathology Research Unit; Medical University of Graz; Graz Austria
| | - L. Requena
- Department of Dermatology; Fundación Jiménez Díaz; Universidad Autónoma; Madrid Spain
| |
Collapse
|
12
|
Peethambaram PP, Hartmann LC, Jonker DJ, de Jonge M, Plummer ER, Martin L, Konner J, Marshall J, Goss GD, Teslenko V, Clemens PL, Cohen LJ, Ahlers CM, Alland L. A phase I pharmacokinetic and safety analysis of epothilone folate (BMS-753493), a folate receptor targeted chemotherapeutic agent in humans with advanced solid tumors. Invest New Drugs 2014; 33:321-31. [PMID: 25380635 DOI: 10.1007/s10637-014-0171-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 10/02/2014] [Indexed: 11/26/2022]
Abstract
Background The folate receptor alpha is selectively over-expressed in a number of human cancers. BMS-753493 is a folate conjugate of the epothilone analog BMS-748285 that was designed to selectively target folate receptor expressing cancer cells. Methods BMS-753493 was investigated in two parallel multi-institutional first-in-human phase I/IIa studies in patients with advanced solid tumors. In Study 1, patients were treated on a schedule of once daily dosing of BMS-753493 administered on Days 1, 4, 8 and 11 every 21 days with a starting dose of 5 mg daily and in Study 2, patients were treated once daily on Days 1-4 every 21 days, with a starting dose of 2.5 mg daily. Results A total of 65 patients were treated across the two studies. The maximum tolerated dose (MTD) was 26 mg in Study 1 and 15 mg in Study 2. Fatigue, transaminitis, gastrointestinal toxicity, and mucositis were dose-limiting toxicities. One patient in Study 2 developed Stevens-Johnson syndrome attributed to BMS-753493. Plasma exposures of both the conjugated and free epothilone increased in a dose related fashion in both studies and the half-life of the conjugated epothilone was 0.2-0.6 h across dose levels. No objective tumor responses were seen in either study. Conclusions BMS-753493 was generally tolerable and toxicities known to be associated with epothilone class of anticancer agents were common, although peripheral neuropathy and neutropenia appear to have been less frequent and less severe as compared to epothilones. Antitumor activity was not demonstrated and further development of BMS-753493 has been discontinued.
Collapse
|
13
|
Picard M, Castells MC. Re-visiting Hypersensitivity Reactions to Taxanes: A Comprehensive Review. Clin Rev Allergy Immunol 2014; 49:177-91. [DOI: 10.1007/s12016-014-8416-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
14
|
Abstract
The incidences of life-threatening toxicities such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are inconsistently reported. The potential association of anticancer agents with SJS or TEN has not been systematically investigated. We searched the literature (Ovid: 1950 to June 2013 and PubMed: 1948 to June 2013) using terms for SJS/TEN and anticancer therapies. Primary case reports, case series, and clinical trials were included. In addition, MedWatch, the Food and Drug Administration Adverse Event Reporting System (FAERS), was searched (1968 to August 2012) for SJS/TEN reports associated with anticancer therapies. Proportional reporting ratios (PRR>2, N>3), empirical Bayes geometric mean (EBGM>2, N>3), and lower 95% confidence interval (EBGM0.05>2) were used as thresholds to constitute a signal of association between SJS/TEN and anticancer drugs. There were 46 SJS and 37 TEN cases associated with 18 and 22 anticancer drugs in the literature, respectively. Among cases in the FAERS, significant signals were associated with SJS for bendamustine and with TEN for bendamustine, busulfan, chlorambucil, fludarabine, lomustine, and procarbazine. Several drugs reported in the published literature to be associated with SJS/TEN were not found to have significant signals in FAERS. Proactive pharmacovigilance to detect and define safety signals serves to aid oncology practitioners in the recognition of possible, yet uncommon, serious, and/or life-threatening skin reactions.
Collapse
|
15
|
Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2010. [DOI: 10.1002/pds.1849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
16
|
Corrigenda. J Eur Acad Dermatol Venereol 2010. [DOI: 10.1111/j.1468-3083.2009.03520.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|