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Abrini H, Amzerin M, El Mrabet FZ. Sorafenib-Induced Erythema Multiforme Major and Severe Hepatic Failure in Metastatic Hepatocellular Carcinoma: A Case Report. Cureus 2024; 16:e57179. [PMID: 38681290 PMCID: PMC11056083 DOI: 10.7759/cureus.57179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 05/01/2024] Open
Abstract
Sorafenib, a kinase inhibitor, is known to cause skin toxicity, which sometimes leads to treatment interruption or drug dose reduction. Erythema multiforme (EM) is one of these dermatologic toxicities induced by sorafenib. We report the case of a 28-year-old male with hepatocellular carcinoma (HCC). Two months after surgery, the patient presented with multiple metastases to the retroperitoneal lymph nodes and lungs. Therefore, systemic therapy with sorafenib was indicated. While receiving the medication, the patient presented signs compatible with EM. The signs occurred on the torso and then spread to the rest of the body. Sorafenib treatment was interrupted the same day when skin lesions appeared and moisturizers with topical steroids and oral antihistamines were prescribed. The skin lesions decreased in size but without significant cutaneous improvement. The patient showed biologically severe liver failure and radiological progression. Because of the severe hepatic failure, initiation of intravenous steroids and establishment of another line of chemotherapy following tumor progression were contraindicated. The decision of the multidisciplinary staff with patient consent was to proceed with the best supportive care. The patient died in ambulatory care 12 days after discharge and local treatment. This report highlights the possibility of developing severe EM while receiving sorafenib. Patients with HCC who have liver resection without liver dysfunction should not be administered sorafenib, or it must be used with caution at very low doses and accompanied by close and regular follow-ups to avoid disease progression and deaths.
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Affiliation(s)
- Houda Abrini
- Department of Medical Oncology, Mohammed VI University Hospital of Tangier, Faculty of Medicine and Pharmacy, Ahmed Bin Zayed Al Nahyan Center of Cancer Treatment, Abdelmalek Essaâdi University, Tangier, MAR
| | - Mounia Amzerin
- Department of Medical Oncology, Mohammed VI University Hospital of Tangier, Faculty of Medicine and Pharmacy, Ahmed Bin Zayed Al Nahyan Center of Cancer Treatment, Abdelmalek Essaâdi University, Tangier, MAR
| | - Fatima Zahra El Mrabet
- Department of Medical Oncology, Mohammed VI University Hospital of Tangier, Faculty of Medicine and Pharmacy, Ahmed Bin Zayed Al Nahyan Center of Cancer Treatment, Abdelmalek Essaâdi University, Tangier, MAR
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2
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Roger I, Montero P, Pérez-Leal M, Milara J, Cortijo J. Evaluation of Delayed-Type Hypersensitivity to Antineoplastic Drugs-An Overview. Cancers (Basel) 2023; 15. [PMID: 36831549 DOI: 10.3390/cancers15041208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [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.
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3
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Irawan A, Prabowo E, Riwanto I, Atmodjo WL. Anti-angiogenic effect of the combination of low-dose sorafenib and EGCG in HCC-induced Wistar rats. F1000Res 2022; 11:289. [PMID: 36726605 PMCID: PMC9843086 DOI: 10.12688/f1000research.109142.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Sorafenib is a standard drug used for advanced hepatocellular carcinoma but is often resistant and toxic. Its combination with epigallo-3-catechin gallate leads to reduced resistance and toxicity but an equally effective anti-angiogenic effect.Therefore, this study aims to assess the anti-angiogenic effect of standard-dose Sorafenib compared to the combination of low-dose Sorafenib and epigallo-3-catechin gallate. Methods: We conducted an animal study and double-blind, randomized controlled trials. A total of 25 male Wistar rats (7-weeks-old) were randomly divided into four groups, namely Sham (K), Control (O), a combination of low-dose Sorafenib and epigallo-3-catechin gallate group (X1), and standard-dose Sorafenib group (X2). All groups were injected with N-Nitrosodiethylamine 70 mg/kg body weight (BW) intraperitoneally for ten weeks, except the Sham group. After the development of hepatocellular carcinoma, X1 and X2 were treated for two weeks. Subsequently, liver tissues were examined for vascular endothelial growth factor (VEGF) level and microvascular density expression. Results: There was a significant difference (p=0.007) in the level of VEGF between group X1 (low dose Sorafenib + EGCG) and X2 (Standard dose Sorafenib). However, the differences in VEGF levels of group X1 and X2 compared to group O(Control) were significantly lower, with values p=0.000136 and p=0.019, respectively. The expression of microvascular density between groups X1 and X2 was not entirely different. Meanwhile, a significant difference (p<0.05) was discovered when both groups were compared with the control group. Conclusion: The combination of low-dose Sorafenib with epigallo-3-catechin gallate is superior in reducing the level of VEGF compared to standard-dose Sorafenib and is better than the control. Standard-dose Sorafenib and the combination of low-dose Sorafenib and epigallo-3-catechin gallate have similar effectivity in reducing the expression of microvascular density and could prevent resistance and lower toxicity effects.
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Affiliation(s)
- Andry Irawan
- Department of Digestive Surgery, Diponegoro University, Semarang, Central Java, Indonesia,
| | - Erik Prabowo
- Department of Digestive Surgery, Diponegoro University, Semarang, Central Java, Indonesia
| | - Ignatius Riwanto
- Department of Digestive Surgery, Diponegoro University, Semarang, Central Java, Indonesia
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4
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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5
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Ziemer M, Fries V, Paulmann M, Mockenhaupt M. Epidermal necrolysis in the context of immuno-oncologic medication as well as kinase inhibitors and biologics. J Dtsch Dermatol Ges 2022; 20:777-786. [PMID: 35711043 DOI: 10.1111/ddg.14711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/30/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Stevens-Johnson syndrome and toxic epidermal necrolysis are severe, primarily drug-induced reactions of skin and mucosa. Since they differ in the extent of skin detachment but not in etiology, they are grouped together as epidermal necrolysis (EN). Due to nationwide registration, representative data are available at the German Center for the Documentation of Severe Skin Reactions (dZh). Here, an increasing number of case notifications in the context with new immuno-oncologic drugs, kinase inhibitors and biologics have been observed. MATERIAL AND METHODS Of 4,150 cases notifications between January 2003 and February 2019, 102 cases with exposure to these drug groups underwent systematic analysis, validation and causality assessment. RESULTS Two cases of EN to vemurafenib were confirmed and one case to afatinib and pembrolizumab, respectively. In 14 EN cases other drugs - predominantly allopurinol or cotrimoxazole - were the causative agent. Fourteen cases were EN-like reactions: six bullous lichenoid drug eruptions (DE) to pembrolizumab (2), obinutuzumab, nivolumab, rituximab, infliximab/nivolumab, and eight multiforme-like DE to rituximab (2), adalimumab, ramucirumab, bevacizumab, vemurafenib, sorafenib (2). Lichenoid DE were differentiated from EN through histopathology and by the protracted course of EN, multiforme-like DE by variable skin manifestations with only sparse epidermolysis or mucosal involvement. CONCLUSIONS A correct diagnosis is highly relevant in terms of prognosis and use of these drugs in malignoma treatment. Re-exposure is contraindicated in EN, but possible in other DE after rigorous risk-benefit evaluation.
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Affiliation(s)
- Mirjana Ziemer
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig, Germany
| | - Viviane Fries
- German Center for the Documentation of Severe Skin Reactions (dZh), Department of Dermatologie, Medical Center and Medical Faculty - University of Freiburg, Germany
| | - Maren Paulmann
- German Center for the Documentation of Severe Skin Reactions (dZh), Department of Dermatologie, Medical Center and Medical Faculty - University of Freiburg, Germany
| | - Maja Mockenhaupt
- German Center for the Documentation of Severe Skin Reactions (dZh), Department of Dermatologie, Medical Center and Medical Faculty - University of Freiburg, Germany
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6
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Ziemer M, Fries V, Paulmann M, Mockenhaupt M. Epidermale Nekrolyse im Zusammenhang mit immunonkologischen Medikamenten, Kinaseinhibitoren sowie Biologika. J Dtsch Dermatol Ges 2022; 20:777-787. [PMID: 35711046 DOI: 10.1111/ddg.14711_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Mirjana Ziemer
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Leipzig
| | - Viviane Fries
- Dokumentationszentrum schwerer Hautreaktionen (dZh), Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg
| | - Maren Paulmann
- Dokumentationszentrum schwerer Hautreaktionen (dZh), Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg
| | - Maja Mockenhaupt
- Dokumentationszentrum schwerer Hautreaktionen (dZh), Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg
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7
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Azhar AF, Saporito RC, Jamerson J. Erythema multiforme after treatment with sorafenib. Proc AMIA Symp 2021; 34:380-381. [PMID: 33953468 DOI: 10.1080/08998280.2021.1877509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Sorafenib, an oral chemotherapeutic agent used in the treatment of solid tumors, is associated with a variety of adverse cutaneous drug reactions in up to 90% of patients. Infrequently, delayed-type hypersensitivity reactions such as erythema multiforme occur. This case describes a child treated with sorafenib for a retrosternal desmoid tumor who developed widespread erythema multiforme across his extremities, trunk, face, and mucosal membranes.
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Affiliation(s)
| | | | - Jordan Jamerson
- Department of Dermatology, Baylor Scott & White Medical Center - Temple, Temple, Texas
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8
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Coleman EL, Olamiju B, Leventhal JS. Potentially life‑threatening severe cutaneous adverse reactions associated with tyrosine kinase inhibitors (Review). Oncol Rep 2020; 45:891-898. [PMID: 33650659 DOI: 10.3892/or.2020.7911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/21/2020] [Indexed: 11/05/2022] Open
Abstract
Tyrosine kinase inhibitors (TKIs) have emerged as a new frontier of cancer therapy. These agents include inhibitors of epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (HER2), BRAF, mitogen‑activated protein kinase kinase (also referred to as MEK), bcr‑abl, c‑KIT, platelet‑derived growth factor (PDGFR), fibroblast growth factor receptor (FGFR), anaplastic lymphoma kinase (ALK) and vascular endothelial growth factor (VEGF). Along with the evolving applications of TKIs, there has been an increased recognition of the breadth of potential cutaneous toxicities to these agents. In this review, we provide an overview of potentially life‑threatening severe cutaneous adverse reactions (SCARs) that may occur during therapy with TKIs. These toxicities include Stevens‑Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP).
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9
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Mantovani A, Álvares-Da-Silva MR. Anaphylaxis preceded by erythema multiforme with sorafenib: First case report. Ann Hepatol 2019; 18:777-9. [PMID: 31085038 DOI: 10.1016/j.aohep.2019.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 02/04/2023]
Abstract
A 63-year-old female patient with recent diagnosis of hepatitis C and cirrhosis and no other comorbidities, on no medications, was found to have Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma and began systemic therapy with sorafenib 400mg twice daily. Five days after starting treatment, the patient went to an emergency department with pruritic, target-shaped, erythematous papules compatible with erythema multiforme, painful oral aphthous ulcers, and fever. Sorafenib was suspended and the patient underwent oral corticosteroid treatment for 5 days, showing significant improvement of the lesions. One month after discharge, the patient was reassessed at an outpatient clinic. As she was asymptomatic and had no skin lesions, sorafenib was resumed at a lower dose (200mg daily). Three hours after ingesting a single dose of sorafenib, the patient experienced chills, fever, rash, angioedema and stridor. She immediately sought the emergency department and was diagnosed with anaphylaxis. The patient received intravenous corticosteroid therapy, which improved her respiratory and cutaneous symptoms in 72h. Sorafenib was permanently suspended, and regorafenib could not be prescribed as second-line therapy. This is the first description of anaphylaxis to sorafenib.
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10
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Mijares MC, Aldahan AS, Gonzalez HH, Jaimes JP. Sorafenib-induced Facial Acneiform Eruption. Cureus 2019; 11:e4545. [PMID: 31275769 PMCID: PMC6592841 DOI: 10.7759/cureus.4545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sorafenib is a multikinase inhibitor that is used to treat hepatocellular carcinoma by inhibiting tumor cell growth and angiogenesis. Cutaneous adverse events of sorafenib are commonly reported, with alopecia and hand-foot skin reactions most frequently encountered. Acneiform eruptions represent rare adverse events that have only been reported at high doses of sorafenib. We present a patient who started low dose sorafenib for hepatocellular carcinoma and subsequently developed a fulminant facial acneiform eruption in the absence of other cutaneous adverse events. Treatment included topical clindamycin and tretinoin with some improvement. Facial acneiform eruption represents a rare consequence of sorafenib that has not previously been described at low doses. Additionally, acneiform papules in the absence of other cutaneous adverse events is unusual. The cutaneous mechanism is not well understood but may be related to indirect epidermal growth factor receptor inhibition or direct cytotoxic effects on eccrine glands. Topical treatment produces only minimal improvement in patients who continue sorafenib therapy. Discontinuation of the drug is usually unwarranted except in special circumstances.
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Affiliation(s)
- Maria C Mijares
- Internal Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
| | | | - Hector H Gonzalez
- Internal Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
| | - Juan P Jaimes
- Dermatology, University of Minnesota, Minneapolis, USA
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11
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12
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Kakiuchi S, Yakushijin K, Sakai R, Kawaguchi K, Higashime A, Kurata K, Ichikawa H, Nagao S, Rikitake J, Kiyota N, Matsuoka H, Minami H. Discontinuation of sorafenib can lead to the emergence of FLT3-ITD-positive acute myeloid leukemia. J Oncol Pharm Pract 2018; 25:2010-2015. [PMID: 30514174 DOI: 10.1177/1078155218816768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 69-year-old woman who had been diagnosed with unresectable papillary thyroid cancer was referred to our hospital. We initially treated her with sorafenib, but she subsequently developed erythema multiforme, which was suspected to be a drug rush due to sorafenib; therefore, sorafenib was discontinued. At the time of discontinuation, immature blast cells were detected in her peripheral blood. Approximately two weeks later, her skin rash improved substantially, but the proportion of blasts in the peripheral blood increased. We performed a bone marrow examination, and she was diagnosed with FLT3-ITD-positive acute myeloid leukemia. FLT3-ITD expression is found in 20-25% of AML and is a known independent poor prognostic factor. To overcome the poor prognosis associated with FLT3-ITD, molecular drugs targeting FLT3-ITD are attracting much attention. Sorafenib, a multi-kinase inhibitor, also has an effect on FLT3-ITD. Although primary disease flares after tyrosine kinase inhibitor discontinuation have been reported, this is the first report to describe discontinuation of sorafenib treatment as a potential trigger of FLT3-ITD-positive acute myeloid leukemia in papillary thyroid cancer.
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Affiliation(s)
- Seiji Kakiuchi
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan.,Department of Hematology, Yodogawa Christian Hospital, Osaka, Osaka, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Rina Sakai
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Koji Kawaguchi
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Ako Higashime
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Keiji Kurata
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Hiroya Ichikawa
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Shigeki Nagao
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan.,Division of Hematology, Department of Internal Medicine, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan
| | - Junpei Rikitake
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan.,Department of Hematology, Yodogawa Christian Hospital, Osaka, Osaka, Japan
| | - Naomi Kiyota
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Hironobu Minami
- Division of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
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13
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Kim JM, Kim HJ, Min BH, Shin JS, Jeong WY, Lee GE, Kim MS, Kim JE, Park CG. Bullous pemphigoid-like skin blistering disease in a rhesus macaque (Macaca mulatta). J Med Primatol 2016; 45:206-8. [PMID: 27373989 DOI: 10.1111/jmp.12225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2016] [Indexed: 11/28/2022]
Abstract
Autoimmune bullous disease is very uncommon in non-human primates. We observed a bullous skin disease in a male rhesus monkey while conducting porcine islet xenotransplantation. Fifty days after the transplantation, multiple bullous skin lesions were observed. There was no mucosal involvement. Skin biopsy results demonstrated a subepidermal blister with no necrotic keratinocytes. Immunofluorescent staining showed linear IgG deposition at the roof of the blister. These skin lesions spontaneously disappeared. Considering these results, this monkey was diagnosed with bullous pemphigoid (BP). As far as we know, this is the first report of BP in non-human primates.
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Affiliation(s)
- Jong-Min Kim
- Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.,Institute of Endemic Diseases, Seoul National University Graduate School, Seoul, Korea
| | - Hyun-Je Kim
- Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University Graduate School, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Byoung-Hoon Min
- Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University Graduate School, Seoul, Korea
| | - Jun-Seop Shin
- Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.,Institute of Endemic Diseases, Seoul National University Graduate School, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University Graduate School, Seoul, Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Won Young Jeong
- Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea
| | - Ga Eul Lee
- Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea
| | - Min Sun Kim
- Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea
| | - Ju Eun Kim
- Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea
| | - Chung-Gyu Park
- Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.,Institute of Endemic Diseases, Seoul National University Graduate School, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University Graduate School, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
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14
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Affiliation(s)
- Dominique C Pichard
- Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Adela R Cardones
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina
| | - Emily Y Chu
- Department of Dermatology, University of Pennsylvania, Philadelphia
| | - William L Dahut
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Heidi H Kong
- Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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15
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Ollech A, Stemmer SM, Merims S, Lotem M, Popovtzer A, Hendler D, Hodak E, Didkovsky E, Amitay-Laish I. Widespread morbilliform rash due to sorafenib or vemurafenib treatment for advanced cancer; experience of a tertiary dermato-oncology clinic. Int J Dermatol 2016; 55:473-8. [DOI: 10.1111/ijd.13153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 05/20/2015] [Accepted: 07/10/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Ayelet Ollech
- Department of Dermatology; Rabin Medical Center; Petach Tikva Israel
| | - Salomon M. Stemmer
- Institute of Oncology; Davidoff Center; Rabin Medical Center; Petach Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Sharon Merims
- Center for Melanoma and Cancer Immunotherapy; Sharett Institute of Oncology; Hadassah Hebrew University Medical Center; Jerusalem Israel
| | - Michal Lotem
- Center for Melanoma and Cancer Immunotherapy; Sharett Institute of Oncology; Hadassah Hebrew University Medical Center; Jerusalem Israel
| | - Aron Popovtzer
- Institute of Oncology; Davidoff Center; Rabin Medical Center; Petach Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Daniel Hendler
- Institute of Oncology; Davidoff Center; Rabin Medical Center; Petach Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Emmilia Hodak
- Department of Dermatology; Rabin Medical Center; Petach Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Elena Didkovsky
- Department of Pathology; Rabin Medical Center; Petach Tikva Israel
| | - Iris Amitay-Laish
- Department of Dermatology; Rabin Medical Center; Petach Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
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Macdonald JB, Macdonald B, Golitz LE, LoRusso P, Sekulic A. Cutaneous adverse effects of targeted therapies: Part I: Inhibitors of the cellular membrane. J Am Acad Dermatol 2015; 72:203-18; quiz 219-20. [PMID: 25592338 DOI: 10.1016/j.jaad.2014.07.032] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 07/22/2014] [Accepted: 07/22/2014] [Indexed: 12/18/2022]
Abstract
There has been a rapid emergence of numerous targeted agents in the oncology community in the last decade. This exciting paradigm shift in drug development lends promise for the future of individualized medicine. Given the pace of development and clinical deployment of targeted agents with novel mechanisms of action, dermatology providers may not be familiar with the full spectrum of associated skin-related toxicities. Cutaneous adverse effects are among the most frequently observed toxicities with many targeted agents, and their intensity can be dose-limiting or lead to therapy discontinuation. In light of the often life-saving nature of emerging oncotherapeutics, it is critical that dermatologists both understand the mechanisms and recognize clinical signs and symptoms of such toxicities in order to provide effective clinical management. Part I of this continuing medical education article will review in detail the potential skin-related adverse sequelae, the frequency of occurrence, and the implications associated with on- and off-target cutaneous toxicities of inhibitors acting at the cell membrane level, chiefly inhibitors of epidermal growth factor receptor, KIT, and BCR-ABL, angiogenesis, and multikinase inhibitors.
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Affiliation(s)
- James B Macdonald
- Department of Dermatology, Central Utah Clinic, Provo, Utah; Department of Pathology, Central Utah Clinic, Provo, Utah.
| | | | - Loren E Golitz
- Department of Dermatology, University of Colorado-Denver, Aurora, Colorado; Department of Pathology, University of Colorado-Denver, Aurora, Colorado
| | - Patricia LoRusso
- Department of Oncology, Wayne State University, Detroit, Michigan
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Abstract
INTRODUCTION Sorafenib is an oral multikinase inhibitor that targets tumor cell angiogenesis and proliferation. Drug-associated cutaneous adverse events, such as alopecia and hand-foot skin reaction, occur frequently. Sorafenib-related side effects affecting hair, nails, and skin are summarized and the characteristics of sorafenib-treated patients who developed acneiform facial lesions are reviewed to present the clinical features of these individuals. CASE REPORT A man with sorafenib-associated facial acneiform lesions mimicking those of chloracne is described. DISCUSSION PubMed was used to search the following terms, separately and in combination: acne, acneiform eruption, chloracne, cutaneous adverse events, hepatocellular carcinoma, renal cell carcinoma, skin side effects, and sorafenib. Inclusion criteria for selecting papers to be reviewed included case reports and studies that described cutaneous and mucosal adverse side effects associated with sorafenib. All papers fulfilling inclusion criteria were reviewed and relevant manuscripts, along with their reference citations, were evaluated. Five patients-a woman with liver epithelioid hemangioendothelioma, three men with metastatic renal cell carcinoma, and a man with hepatocellular carcinoma-have developed sorafenib-associated facial acneiform eruption. The eruption typically occurred after 4 weeks of treatment at a dose of 400 mg twice daily. The lesions presented as either papules and pustules (2 patients) or, similar in appearance and distribution to chloracne, only open and closed comedones (3 patients). The sorafenib-associated facial acneiform eruption partially improved after initiating topical antibiotics, keratolytics, and/or retinoids; however, progressive improvement or resolution occurred after lowering the daily dose or discontinuation of sorafenib. CONCLUSIONS Sorafenib-associated facial acneiform eruption is a rarely occurring cutaneous adverse event that has only been observed in five individuals. The skin lesions usually presented after 4 weeks of sorafenib (at a dose of 400 mg twice daily) treatment. The morphology and distribution of the lesions mimicked those of chloracne in three of the patients. Two of the patients also had other drug-related skin side effects. Topical acne-directed therapy was only partially effective in clearing the lesions; lowering the dose or discontinuation of sorafenib resulted in progressive improvement or resolution of the facial acneiform eruption.
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Sohn KH, Oh SY, Lim KW, Kim MY, Lee SY, Kang HR. Sorafenib induces delayed-onset cutaneous hypersensitivity: a case series. Allergy Asthma Immunol Res 2014; 7:304-7. [PMID: 25749785 PMCID: PMC4397373 DOI: 10.4168/aair.2015.7.3.304] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 06/25/2014] [Accepted: 07/11/2014] [Indexed: 01/05/2023]
Abstract
Sorafenib is an oral multikinase inhibitor with clinical activity against hepatocellular carcinoma (HCC) and renal cell carcinoma. Administration of sorafenib carries a variety of adverse cutaneous reactions. Common adverse effects induced by sorafenib include hand-foot skin reactions, facial erythema, splinter subungual hemorrhage, and alopecia. Although erythema multiforme (EM) related to sorafenib has been reported, delayed-type cutaneous hypersensitivity reactions are rare in patients treated with sorafenib and there has been no case of Stevens-Johnson syndrome (SJS) reported so far. We recently experienced 3 cases of delayed-type cutaneous hypersensitivity related to administration of sorafenib. The first case was a 47-year female had targetoid erythematous rashes on her arms 12 days after starting sorafenib for HCC. The rashes spread from the arms to the trunk rapidly except for the hands and feet, and erosive lesions developed in the oral mucosa and lips. She was diagnosed as SJS. The second case was an 81-year-old male had maculopapular eruptions with multiple targetoid lesions on the trunk, arms, and legs 10 days after starting sorafenib for his HCC. There was no evidence of mucosal involvement. He was diagnosed with EM. The last one was a 20-year-old female developed generalized maculopapular eruptions in the whole body 10 days after starting sorafenib for the treatment of HCC. All 3 patients completely recovered after discontinuation of sorafenib.
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Affiliation(s)
- Kyoung Hee Sohn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
| | - Soo Yeon Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Whan Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
| | - Mi Yeong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
| | - Suh Young Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.; Seoul National University Hospital Regional Pharmacovigilance Center, Seoul, Korea
| | - Hye Ryun Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.; Seoul National University Hospital Regional Pharmacovigilance Center, Seoul, Korea.
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Tsuchiya N, Narita S, Inoue T, Hasunuma N, Numakura K, Horikawa Y, Satoh S, Notoya T, Fujishima N, Hatakeyama S, Ohyama C, Habuchi T. Risk factors for sorafenib-induced high-grade skin rash in Japanese patients with advanced renal cell carcinoma. Anticancer Drugs. 2013;24:310-314. [PMID: 23237922 DOI: 10.1097/cad.0b013e32835c401c] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The aim of this study was to evaluate the clinical factors, drug-related genetic polymorphisms, and human leukocyte antigen (HLA) types to determine the association with sorafenib-induced high-grade skin rash (HGSR) in Japanese patients with advanced renal cell carcinoma (RCC). A total of 55 patients with advanced RCC treated with sorafenib were analyzed retrospectively. Of these, 33 patients were subjected to HLA typing and polymorphism analyses of CYP3A5, ABCB1, ABCC2, and UGT1A1, which are involved in the metabolism and membrane transport of sorafenib. Grade 3 or higher SR developed in 12 (22%), and a higher incidence was observed in female patients than in male patients (40 vs. 15%, P=0.046). The initial dose, initial dose per body weight, and initial dose per body surface area in patients with HGSR were significantly higher than those in patients without HGSR. Patients with the ABCC2 -24CC genotype were at a significantly higher risk of SR than those with the CT genotype (35 vs. 0%, P=0.032). HLA-A*24 was significantly associated with the occurrence of HGSR (P=0.049). Our finding suggested that women, higher initial dose per body weight or body surface area, the ABCC2 -24CC genotype, and HLA-A*24 are associated with the risk of sorafenib-induced HGSR in Japanese RCC patients.
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Ikeda M, Fujita T, Mii S, Tanabe KI, Tabata KI, Matsumoto K, Satoh T, Iwamura M. Erythema multiforme induced by sorafenib for metastatic renal cell carcinoma. Jpn J Clin Oncol 2012; 42:820-4. [PMID: 22782962 DOI: 10.1093/jjco/hys103] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Sorafenib is one of the few standard agents for metastatic renal cell carcinoma. Although sorafenib-induced erythema multiforme is rarely reported, we evaluated the cases of erythema multiforme induced by sorafenib for metastatic renal cell carcinoma. METHODS From November 2006 to November 2011, 36 eligible patients who had been treated with sorafenib were enrolled in this study. Patients received sorafenib 200 or 400 mg orally, twice daily, at 12 h intervals, on a continuous dosing schedule. All patients who experienced rash or erythema multiforme underwent a skin biopsy, and the histopathological diagnosis was confirmed. RESULTS Twenty-eight patients (78%) experienced a skin reaction of any toxicity grade. Hand-foot skin reactions occurred in 17 (47%), erythema multiforme in 9 (25%), rash/desquamation in 6 (17%) and alopecia in 9 (25%). Skin biopsy was performed and histopathological diagnosis was confirmed for all nine patients (25%) who experienced erythema multiforme. All nine showed a positive reaction to sorafenib on a subsequent patch test. CONCLUSIONS Sorafenib-induced erythema multiforme may not be rare in Japanese patients. Patients who once showed erythema multiforme after sorafenib treatment are never to be treated with sorafenib again. Patients treated with sorafenib should be monitored carefully, with a multidisciplinary approach. Consultation with a dermatologist is critical because some cases quickly become severe.
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Affiliation(s)
- Masaomi Ikeda
- Department of Urology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 252-0374, Japan.
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Kodaira M, Takahashi S, Takeuchi K, Yuasa T, Saotome T, Yonese J, Fukui I, Hatake K. Sorafenib-induced erythema multiforme for metastatic renal cell carcinoma. Ann Oncol 2010; 21:1563-1565. [PMID: 20573851 DOI: 10.1093/annonc/mdq299] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Kodaira
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - S Takahashi
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research.
| | | | - T Yuasa
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - T Saotome
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - J Yonese
- Department of Urology, Cancer Institute of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - I Fukui
- Department of Urology, Cancer Institute of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - K Hatake
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research
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Bilaç C, Müezzinoğlu T, Ermertcan AT, Kayhan TC, Temeltaş G, Oztürkcan S, Temiz P. Sorafenib-induced erythema multiforme in metastatic renal cell carcinoma. Cutan Ocul Toxicol 2009; 28:90-2. [PMID: 19514932 DOI: 10.1080/15569520902915469] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Sorafenib is a new therapeutic agent being used in metastatic renal cell carcinoma, hepatocellular carcinoma, and malignant melanoma. The most frequently seen cutaneous side effects due to sorafenib are erythema, exfoliative dermatitis, acne vulgaris, and flushing. Folliculitis, eczema, and erythema multiforme are other, rare side effects of sorafenib. A 59-year-old man underwent left radical nephrectomy due to renal cell carcinoma 8 months ago, and after the operation he received immunochemotherapy and then sorafenib. On the third day of sorafenib therapy his lesions occurred. His dermatologic examination revealed multiple erythematous papules on his neck, arms, and legs and bullae and iris lesions on his palms and soles. He was diagnosed as having erythema multiforme. In the literature we found only 1 other erythema multiforme case due to sorafenib. We present this interesting case to show and discuss cutaneous side effects of sorafenib, especially erythema multiforme as a very rare cutaneous side effect.
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Affiliation(s)
- Cemal Bilaç
- Department of Dermatology, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
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Okamoto I, Miyazaki M, Morinaga R, Kaneda H, Ueda S, Hasegawa Y, Satoh T, Kawada A, Fukuoka M, Fukino K, Tanigawa T, Nakagawa K. Phase I clinical and pharmacokinetic study of sorafenib in combination with carboplatin and paclitaxel in patients with advanced non-small cell lung cancer. Invest New Drugs 2009; 28:844-53. [PMID: 19760364 PMCID: PMC2955234 DOI: 10.1007/s10637-009-9321-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Accepted: 09/02/2009] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Unsatisfactory efficacy of current treatments for advanced lung cancer has prompted the search for new therapies, with sorafenib, a multikinase inhibitor, being one candidate drug. This phase I trial was conducted to evaluate drug safety and pharmacokinetics as well as tumor response of sorafenib in combination with paclitaxel and carboplatin in patients with advanced non-small cell lung cancer (NSCLC). METHODS Eligible patients received paclitaxel (200 mg/m(2)) and carboplatin (area under the curve [AUC]of 6 mg min mL(-1)) on day 1 and sorafenib (400 mg, twice daily) on days 2 through 19 of a 21-day cycle. RESULTS Four of the initial six patients (cohort 1) experienced dose-limiting toxicities (DLTs), resulting in amendment of the treatment protocol. An additional seven patients (cohort 2) were enrolled, two of whom developed DLTs. DLTs included erythema multiforme, hand-foot skin reaction, and elevated plasma alanine aminotransferase in cohort 1 as well as gastrointestinal perforation at a site of metastasis and pneumonia in cohort 2. Most adverse events were manageable. One complete and six partial responses were observed among the 12 evaluable patients. Coadministration of the three drugs had no impact on their respective pharmacokinetics. CONCLUSION The present study confirmed that sorafenib at 400 mg once daily in combination with carboplatin AUC 5 mg min mL(-1) and paclitaxel 200 mg/m(2) is feasible in Japanese patients with advanced NSCLC. The results of this study also showed that this combination therapy had encouraging antitumor activity and was not associated with relevant pharmacokinetic interaction in Japanese NSCLC patients.
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Affiliation(s)
- Isamu Okamoto
- Department of Medical Oncology, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
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Velázquez D, de la Cueva P, Zamberk P, Lázaro P. Toxicodermia inducida por sorafenib. Actas Dermo-Sifiliográficas 2009. [DOI: 10.1016/s0001-7310(09)71605-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Wolber C, Udvardi A, Tatzreiter G, Schneeberger A, Volc-Platzer B. Perforating folliculitis, angioedema, hand-foot syndrome--multiple cutaneous side effects in a patient treated with sorafenib. J Dtsch Dermatol Ges 2009; 7:449-52. [PMID: 19178612 DOI: 10.1111/j.1610-0387.2009.07017.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A patient with clear cell renal cell carcinoma was treated with sorafenib, a multikinase inhibitor, which induced a variety of cutaneous side effects. In addition to xerosis, he developed angioedema (AE), hand-foot syndrome (HFS) and perforating folliculitis (PF). The latter three occurred in a dose-dependent manner. AE was observed at the recommended daily dose of 800 mg. Dose reduction to 400 mg prevented its recurrence. At this dose level, the patient exhibited HFS, which cleared upon further reduction of the dose. While receiving 200 mg, the patient developed PF. To the best of our knowledge, this is the first description of a case of PF during treatment with sorafenib.
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Affiliation(s)
- Carola Wolber
- Donauspital SMZ Ost, Department of Dermatology and Venereology, Vienna, Austria.
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Velázquez D, de la Cueva P, Zamberk P, Lázaro P. Dermatologic Toxicity to Sorafenib. Actas Dermo-Sifiliográficas (English Edition) 2009. [DOI: 10.1016/s1578-2190(09)70115-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Galán Brotons A, Borrás-blasco J, Rosique Robles JD, Vicent Verge JM, Casterá E. Generalised erythematous skin eruptions induced by sorafenib: cutaneous toxicity and treatment outcome. Clin Transl Oncol 2008; 10:844-6. [DOI: 10.1007/s12094-008-0299-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lopez V, Pinazo I, Marti N, Monteagudo C, Jorda E. Follicular hyperplasia on the face subsequent to therapy with sorafenib. A new skin side effect. J Eur Acad Dermatol Venereol 2008; 23:959-60. [PMID: 18785888 DOI: 10.1111/j.1468-3083.2008.03003.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Deslandres M, Sibaud V, Chevreau C, Delord J. Effets secondaires cutanés des nouvelles molécules anticancéreuses : focus sur les molécules ciblant les récepteurs tyrosine kinase et le récepteur à l’EGF. Ann Dermatol Venereol 2008; Spec No 1:16-24. [DOI: 10.1016/s0151-9638(08)70093-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Management of advanced hepatocellular carcinoma (HCC) is still a challenge to physicians since these patients are not candidates for surgical or ablative therapy. The disease carries a very poor prognosis with an expected survival of 4-6 months. No chemotherapeutic agent has been proven to improve the clinical outcome in such patients. A multikinase inhibitor, sorafenib, previously tested and found effective in other solid tumors recently found to significantly improve survival in patients with advanced HCC. Sorafenib exerts its action through inhibition of several kinases involved in both tumour cell proliferation and angiogenesis. It was well tolerated at a dose of 400 mg twice daily and permanent discontinuation of the drug was rarely required.
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Affiliation(s)
- Ali Ben Mousa
- Division of Gastroenterology and Hepatology, Department of Medicine, Riyadh Military Hospital, Riyadh, Saudi Arabia,Address: Ali Ben Mousa, Division of Gastroenterology and Hepatology, Department of Medicine Riyadh Military Hospital, P.O. Box 7897, Riyadh 11159, Saudi Arabia. E-mail:
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