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Cintra M, Pedraza Cezón LA, Martín Navarro JA, Torres Aguilera E, Albalate Ramón M, Alcázar Arroyo R, Procaccini F, Puerta Carretero M, Ortega Díaz M, Medina Zahonero L, Jaldo Rodríguez MT, de Sequera P. Acute renal failure due to rhabdomyolysis in relation to abiraterone and rosuvastatin. Nefrologia 2023; 43:374-376. [PMID: 37500306 DOI: 10.1016/j.nefroe.2021.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/06/2021] [Indexed: 07/29/2023] Open
Affiliation(s)
- Melissa Cintra
- Servicio de Nefrología, Hospital Infanta Leonor, Madrid, Spain.
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Cintra M, Pedraza Cezón LA, Martín Navarro JA, Torres Aguilera E, Albalate Ramón M, Alcázar Arroyo R, Procaccini F, Puerta Carretero M, Ortega Díaz M, Medina Zahonero L, Jaldo Rodríguez MT, de Sequera P. Acute renal failure due to rhabdomyolysis in relation to abiraterone and rosuvastatin. Nefrologia 2021; 43:S0211-6995(21)00165-X. [PMID: 34503863 DOI: 10.1016/j.nefro.2021.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/06/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Melissa Cintra
- Servicio de Nefrología, Hospital Infanta Leonor, Madrid, España.
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Scailteux LM, Despas F, Balusson F, Campillo-Gimenez B, Mathieu R, Vincendeau S, Happe A, Nowak E, Kerbrat S, Oger E. Hospitalization for adverse events under abiraterone or enzalutamide exposure in real-world setting: A French population-based study on prostate cancer patients. Br J Clin Pharmacol 2021; 88:336-346. [PMID: 34224605 DOI: 10.1111/bcp.14972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/04/2021] [Accepted: 06/21/2021] [Indexed: 12/28/2022] Open
Abstract
AIMS Safety profiles of abiraterone and enzalutamide rely mainly on Phase III clinical trials. Our objective was to estimate the incidence rate ratio (IRR) for certain adverse events leading in real life to hospitalization (atrial fibrillation, acute heart failure, ischaemic heart disease, acute kidney injury [AKI], ischaemic stroke, torsade de pointe/QT interval prolongation, hepatitis and seizure), comparing abiraterone to enzalutamide. We also set out to discuss previously identified safety signals. METHOD Using the French National Health Insurance System database, all patients newly exposed to abiraterone or enzalutamide between 2013 and 2017 and followed until 31 December 2018 were targeted. IRRs for each event were estimated using a Poisson model in a sub-population of patients without contraindications or precautions for use for either treatment. RESULTS Among 11 534 new users of abiraterone and enzalutamide, AKI (IRR 1.42, 95% CI: 1.01-2.00), liver monitoring suggestive of hepatic damage (IRR 3.06, 95% CI: 2.66-3.53) and atrial fibrillation (IRR 1.12, 95% CI: 1.05-1.19) were significantly more often observed with abiraterone than with enzalutamide. CONCLUSION Our study provides knowledge on abiraterone and enzalutamide real-life safety profiles, especially for events leading to hospitalization. Despite several limitations, including the lack of clinical data, the safety signal for AKI under abiraterone is in line with results of an analysis of the French pharmacovigilance database, which requires further specific investigations. Enlightening the clinicians' therapeutic choices for patients treated for prostate cancer, our study should lead to clinicians being cautious in the use of abiraterone.
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Affiliation(s)
- Lucie-Marie Scailteux
- Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Department of Clinical Pharmacology, Rennes University Hospital, Rennes, France.,EA 7449 REPERES 'Pharmacoepidemiology and Health Services Research', Univ Rennes, Rennes, France.,PEPS research consortium, Rennes, France
| | - Fabien Despas
- Department of Clinical Pharmacology, Toulouse University Hospital, Toulouse, France.,INSERM CIC 1436 Toulouse, Centre d'Investigation Clinique de Toulouse, Centre Hospitalier Universitaire de Toulouse, France
| | - Frédéric Balusson
- EA 7449 REPERES 'Pharmacoepidemiology and Health Services Research', Univ Rennes, Rennes, France
| | - Boris Campillo-Gimenez
- Eugène Marquis Comprehensive Cancer Regional Center, Rennes, France.,INSERM 1099 'LTSI', Univ Rennes, Rennes, France
| | - Romain Mathieu
- Urology Department, Rennes University Hospital, Rennes, France.,CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Univ Rennes, Rennes, France
| | | | - André Happe
- EA 7449 REPERES 'Pharmacoepidemiology and Health Services Research', Univ Rennes, Rennes, France.,PEPS research consortium, Rennes, France
| | - Emmanuel Nowak
- PEPS research consortium, Rennes, France.,Université de Bretagne Loire, Université de Brest, INSERM CIC 1412, CHRU de Brest, France
| | - Sandrine Kerbrat
- EA 7449 REPERES 'Pharmacoepidemiology and Health Services Research', Univ Rennes, Rennes, France.,PEPS research consortium, Rennes, France
| | - Emmanuel Oger
- Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Department of Clinical Pharmacology, Rennes University Hospital, Rennes, France.,EA 7449 REPERES 'Pharmacoepidemiology and Health Services Research', Univ Rennes, Rennes, France.,PEPS research consortium, Rennes, France
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4
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Scailteux LM, Lacroix C, Bergeron S, Despas F, Sassier M, Triquet L, Picard S, Oger E, Polard E. [Adverse drug reactions profiles for abiraterone and enzalutamide: A pharmacovigilance descriptive analysis]. Therapie 2020; 76:455-465. [PMID: 33376005 DOI: 10.1016/j.therap.2020.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to describe the profile of adverse drug reactions (ADRs) observed with abiraterone and enzalutamide, based on cases registered in the French regional pharmacovigilance centres to identify potential pharmacovigilance signals. METHODS We extracted from the French pharmacovigilance database all cases of ADRs or drug interactions involving abiraterone or enzalutamide from the time they market authorization date until December 31st, 2017. Signal detection results have been transmitted by the French Agency for Health Products (ANSM). The data were compared with those of the risk management plans for each drug and the literature. RESULTS Among the 233 observations analyzed, nearly 62% involved abiraterone as a suspect drug and 38% involved enzalutamide; only 1 case involved both drugs. The ADRs profile is different between the drugs. Abiraterone is mostly associated with expected cardiac diseases (heart failure, and QT prolongation), expected with the drug. Also described, several cases of hepatotoxicity have been reported, however some cases with fatal outcome suggest that despite a follow-up of the liver function tests, it is difficult to anticipate this risk. Signals concerning acute renal failure and ischemic stroke have arisen. Enzalutamide is more particularly associated with various neurological disorders (convulsions, hallucinations, fatigue, and memory impairment) expected with the drug. While ischemic heart disease is also expected, signals of heart failure and atrial fibrillation have arisen. A potential hepatotoxicity of the molecule is discussed because of cases of cholestatic hepatitis. CONCLUSION The analysis of the French pharmacovigilance database cases allows to confirm an expected and monitored risk profile in the risk management plan for both drugs. Several signals have arisen, some of which will be investigated through a pharmacoepidemiology study.
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Affiliation(s)
- Lucie-Marie Scailteux
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, CHU de Rennes, rue Henri Le Guilloux, 35000 Rennes, France; EA 7449 REPERES, université Rennes, 35000 Rennes, France.
| | - Clémence Lacroix
- Service de pharmacologie clinique, centre régional de pharmacovigilance, Inserm, institut de neuroscience des systèmes UMR 1106, Aix Marseille université, AP-HM, 13005 Marseille, France
| | - Sandrine Bergeron
- UMR-S1172, degenerative and vascular cognitive disorders, Lille neuroscience and cognition, Inserm, CHU de Lille, université Lille, 59000 Lille, France
| | - Fabien Despas
- Service de pharmacologie médicale et clinique, Inserm 1027, facultés de médecine, CHU, université Paul-Sabatier, 31000 Toulouse, France
| | - Marion Sassier
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, CHU de Caen, 14000 Caen, France
| | - Louise Triquet
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, CHU de Rennes, rue Henri Le Guilloux, 35000 Rennes, France
| | - Sylvie Picard
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, CHU de Rennes, rue Henri Le Guilloux, 35000 Rennes, France
| | - Emmanuel Oger
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, CHU de Rennes, rue Henri Le Guilloux, 35000 Rennes, France; EA 7449 REPERES, université Rennes, 35000 Rennes, France
| | - Elisabeth Polard
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, CHU de Rennes, rue Henri Le Guilloux, 35000 Rennes, France; EA 7449 REPERES, université Rennes, 35000 Rennes, France
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5
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Zou L, Matsson P, Stecula A, Ngo HX, Zur AA, Giacomini KM. Drug Metabolites Potently Inhibit Renal Organic Anion Transporters, OAT1 and OAT3. J Pharm Sci 2020; 110:347-353. [PMID: 32910949 DOI: 10.1016/j.xphs.2020.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/19/2020] [Accepted: 09/02/2020] [Indexed: 12/19/2022]
Abstract
Human OAT1 and OAT3 play major roles in renal drug elimination and drug-drug interactions. However, there is little information on the interactions of drug metabolites with transporters. The goal of this study was to characterize the interactions of drug metabolites with OAT1 and OAT3 and compare their potencies of inhibition with those of their corresponding parent drugs. Using HEK293 cells stably transfected with OAT1 and OAT3, 25 drug metabolites and their corresponding parent drugs were screened for inhibitory effects on OAT1-and OAT3-mediated 6-carboxyfluorescein uptake at a screening concentration of 200 μM for all but 3 compounds. 20 and 24 drug metabolites were identified as inhibitors (inhibition > 50%) of OAT1 and OAT3, respectively. Seven drug metabolites were potent inhibitors of either or both OAT1 and OAT3 with Ki values less than 1 μM. 22 metabolites were more potent inhibitors of OAT3 than OAT1. Importantly, one drug and four metabolites were predicted to inhibit OAT3 at unbound plasma concentrations achieved clinically (Cmax,u/Ki values ≥ 0.1). In conclusion, our study highlights the potential interactions of drug metabolites with OAT1 and OAT3 at clinically relevant concentrations, suggesting that drug metabolites may modulate therapeutic and adverse drug response by inhibiting renal drug transporters.
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Affiliation(s)
- Ling Zou
- Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, University of California, San Francisco, CA, USA
| | - Pär Matsson
- Unit for Pharmacokinetics and Drug Metabolism, Department of Pharmacology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Adrian Stecula
- Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, University of California, San Francisco, CA, USA
| | - Huy X Ngo
- Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, University of California, San Francisco, CA, USA
| | - Arik A Zur
- Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, University of California, San Francisco, CA, USA
| | - Kathleen M Giacomini
- Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, University of California, San Francisco, CA, USA.
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Abstract
One of the prominent problems in clinical medicine is medication-induced acute kidney injury (AKI). Avoiding this problem can prevent patient harm and reduce healthcare expenditures. Several researches have been conducted to identify AKI-associated medications using statistical, data mining, and machine learning techniques. However, these studies are limited to assessing the impact of known nephrotoxic medications and do not comprehensively explore the relationship between medication combinations and AKI. In this paper, we present a population-based retrospective cohort study that employs automated data analysis techniques to identify medications and medication combinations that are associated with a higher risk of AKI. By integrating multivariable logistic regression, frequent itemset mining, and stratified analysis, this study is designed to explore the complex relationships between medications and AKI in such a way that has never been attempted before. Through an analysis of prescription records of one million older patients stored in the healthcare administrative dataset at ICES (an independent, non-profit, world-leading research organization that uses population-based health and social data to produce knowledge on a broad range of healthcare issues), we identified 55 AKI-associated medications among 595 distinct medications and 78 AKI-associated medication combinations among 7748 frequent medication combinations. In addition, through a stratified analysis, we identified 37 cases where a particular medication was associated with increasing the risk of AKI when used with another medication. We have shown that our results are consistent with previous studies through consultation with a nephrologist and an electronic literature search. This research demonstrates how automated analysis techniques can be used to accomplish data-driven tasks using massive clinical datasets.
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Ould-Nana I, Cillis M, Gizzi M, Gillion V, Hantson P, Gérard L. Rhabdomyolysis and acute kidney injury induced by the association of rosuvastatin and abiraterone: A case report and review of the literature. J Oncol Pharm Pract 2020; 27:216-219. [DOI: 10.1177/1078155220923001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Introduction Abiraterone acetate is an inhibitor of androgens biosynthesis, approved as first-line treatment in castration-resistant prostate cancer and metastatic castration-sensitive prostate cancer. Abiraterone has been rarely associated with severe rhabdomyolysis, but the mechanism of muscle toxicity is unknown. Case report We hereby present a case of severe rhabdomyolysis resulting in acute on chronic kidney injury following abiraterone initiation in a patient previously under rosuvastatin. Management and outcome Rhabdomyolysis was resolutive after rosuvastatin and abiraterone discontinuation, and kidney function recovered. There was no recurrence of muscle toxicity after re-initiation of abiraterone alone. Discussion Abiraterone selectively inhibits CYP17 as well as the hepatic transporter OATP1B1. OATP1B1 is an efflux transporter, whose function is to extract several drugs from the portal blood, allowing them to undergo hepatic metabolism. We hypothesize that abiraterone-induced inhibition of plasmatic uptake of rosuvastatin by OATP1B1 increased plasmatic concentration of rosuvastatin, leading to toxicity on muscle cells. We therefore suggest that the association between rosuvastatin and abiraterone should be avoided.
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Affiliation(s)
- Ismail Ould-Nana
- Department of Intensive Care, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Marine Cillis
- Department of Clinical Pharmacy, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Marco Gizzi
- Department of Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Valentine Gillion
- Department of Nephrology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Philippe Hantson
- Department of Intensive Care, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Ludovic Gérard
- Department of Intensive Care, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Desikan SP, Sobash P, Fisher A, Desikan R. Statin-Induced Rhabdomyolysis Due to Pharmacokinetic Changes From Biliary Obstruction in a Patient With Metastatic Prostate Cancer. J Investig Med High Impact Case Rep 2020; 8:2324709620947275. [PMID: 32755252 PMCID: PMC7543161 DOI: 10.1177/2324709620947275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Statins work synergistically with androgen receptor blockers and androgen biosynthesis inhibitors, improving survival in patients with metastatic castration resistant prostate cancers (mCRPCs). Survival improvement is more pronounced for patients receiving androgen biosynthesis inhibitors compared with patients receiving androgen receptor blockers. A rare adverse interaction between simvastatin and abiraterone (Zytiga), an androgen biosynthesis inhibitor, was observed in a patient with mCRPC due to pharmacokinetic changes resulting from obstructive jaundice.
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Dineen M, Hansen E, Guancial E, Sievert L, Sahasrabudhe D. Abiraterone-induced rhabdomyolysis resulting in acute kidney injury: A case report and review of the literature. J Oncol Pharm Pract 2017; 24:314-318. [DOI: 10.1177/1078155217701294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abiraterone, a CYP17 inhibitor, blocks androgen biosynthesis in multiple tissue types. In combination with prednisone, it is approved as a first-line treatment for metastatic castration-resistant prostate cancer. We present a case of rhabdomyolysis associated with abiraterone therapy resulting in acute on chronic kidney injury in a patient with metastatic castration-resistant prostate cancer. Strict monitoring should be employed in patients started on abiraterone who have additional risk factors for developing rhabdomyolysis.
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Affiliation(s)
- Michael Dineen
- Wegmans School of Pharmacy, St. John Fisher College, Rochester, NY, USA
| | | | | | - Lynn Sievert
- University of Rochester Medical Center, Rochester, NY, USA
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Crawford ED, Shore ND, Petrylak DP, Higano CS, Ryan CJ. Abiraterone acetate and prednisone in chemotherapy-naïve prostate cancer patients: rationale, evidence and clinical utility. Ther Adv Med Oncol 2017; 9:319-333. [PMID: 28529549 PMCID: PMC5424866 DOI: 10.1177/1758834017698644] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abiraterone acetate 1000 mg/day, combined with prednisone 5 mg PO twice daily, is indicated for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Abiraterone acetate is the oral prodrug of abiraterone, a specific CYP17 inhibitor that blocks androgen biosynthesis within the adrenal glands, testes and tumor microenvironment. In a phase III trial of men with asymptomatic or minimally symptomatic, chemotherapy-naïve mCRPC, treatment with oral abiraterone acetate plus prednisone led to a statistically significant improvement in the co-primary endpoints of overall survival and radiographic progression-free survival when compared with placebo plus prednisone. In long-term follow-up of phase III trials, the incidence of corticosteroid-associated adverse events was 25.5% in the abiraterone acetate plus prednisone arm compared with 23.3% in the placebo plus prednisone arm. The need for regular patient monitoring and appropriate management of symptoms during long-term use of prednisone must be placed in context with the improvement in survival seen with abiraterone plus prednisone. Within the multidisciplinary environment that is emerging to meet quality and cost imperatives, abiraterone acetate plus prednisone is suitable for use in the chemotherapy-naïve population with minimal symptoms as well as in patients who have been treated with docetaxel and may have symptomatic disease. Ongoing trials are evaluating the role of abiraterone acetate plus prednisone in patients with nonmetastatic CRPC and metastatic hormone-sensitive prostate cancer, while further trials in the mCRPC setting are evaluating its use in combination regimens.
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Affiliation(s)
- E David Crawford
- Professor of Surgery/Urology/Radiation Oncology, Head Urologic Oncology, University of Colorado, Denver, Mail Stop #F 710, PO Box #6510, Aurora, CO 80045, USA
| | - Neal D Shore
- Carolina Urologic Research Center, Myrtle Beach, SC, USA
| | | | - Celestia S Higano
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Charles J Ryan
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
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Antineoplastic Treatment and Renal Injury: An Update on Renal Pathology Due to Cytotoxic and Targeted Therapies. Adv Anat Pathol 2016; 23:310-29. [PMID: 27403615 DOI: 10.1097/pap.0000000000000122] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cancer patients experience kidney injury from multiple sources, including the tumor itself, diagnostic procedures, hypovolemia, infection, and drug exposure, superimposed upon baseline chronic damage. This review will focus on cytotoxic or targeted chemotherapy-associated renal injury. In this setting, tubulointerstitial injury and thrombotic microangiopathy (vascular injury) are more common than other forms of kidney injury including glomerular. Cisplatin, pemetrexed, and ifosfamide are well-known causes of acute tubular injury/necrosis. Acute interstitial nephritis seems underrecognized in this clinical setting. Interstitial nephritis is emerging as an "immune-related adverse effect" (irAE's) with immune checkpoint inhibitors in small numbers of patients. Acute kidney injury is rarely reported with targeted therapies such as BRAF inhibitors (vemurafinib, dabrafenib), ALK inhibitors (crizotinib), and mTOR inhibitors (everolimus, temsirolimus), but additional biopsy data are needed. Tyrosine kinase inhibitors and monoclonal antibodies that block the vascular endothelial growth factor pathway are most commonly associated with thrombotic microangiopathy. Other causes of thrombotic microangiopathy in the cancer patients include cytotoxic chemotherapies such as gemcitabine and mitomycin C, hematopoietic stem cell transplant, and cancer itself (usually high-stage adenocarcinoma with marrow and vascular invasion). Cancer patients are historically underbiopsied, but biopsy can reveal type, acuity, and chronicity of renal injury, and facilitate decisions concerning continuation of chemotherapy and/or initiation of renoprotective therapy. Biopsy may also reveal unrelated and unanticipated findings in need of treatment.
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Koršić M, Muršić D, Badovinac S, Božina N, Roglić M, Jakopović M, Čučević B. Erlotinib-related rhabdomyolysis: the role of pharmacogenetics and drug–drug interaction. Cancer Chemother Pharmacol 2015; 76:1317-9. [DOI: 10.1007/s00280-015-2885-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022]
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