1. Targeted therapies for renal cell carcinoma: review of adverse event management strategies.
- Author
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Eisen T, Sternberg CN, Robert C, Mulders P, Pyle L, Zbinden S, Izzedine H, and Escudier B
- Subjects
- Anorexia chemically induced, Anorexia therapy, Antibodies, Monoclonal, Humanized adverse effects, Antineoplastic Agents administration & dosage, Antineoplastic Agents pharmacology, Antineoplastic Combined Chemotherapy Protocols adverse effects, Benzenesulfonates adverse effects, Bevacizumab, Cardiovascular System drug effects, Drug Eruptions therapy, Europe, Everolimus, Evidence-Based Medicine, Gastrointestinal Tract drug effects, Humans, Hypothyroidism chemically induced, Hypothyroidism therapy, Indazoles, Indoles adverse effects, Niacinamide analogs & derivatives, Phenylurea Compounds, Pneumonia chemically induced, Pneumonia therapy, Protein Kinase Inhibitors adverse effects, Protein-Tyrosine Kinases antagonists & inhibitors, Pyridines adverse effects, Pyrimidines adverse effects, Pyrroles adverse effects, Sirolimus adverse effects, Sirolimus analogs & derivatives, Sorafenib, Sulfonamides adverse effects, Sunitinib, TOR Serine-Threonine Kinases antagonists & inhibitors, Vascular Endothelial Growth Factor A antagonists & inhibitors, Weight Loss drug effects, Wound Healing drug effects, Antineoplastic Agents adverse effects, Carcinoma, Renal Cell drug therapy, Carcinoma, Renal Cell metabolism, Kidney Neoplasms drug therapy, Kidney Neoplasms metabolism, Molecular Targeted Therapy methods
- Abstract
With the advent of targeted agents for the treatment of renal cell carcinoma (RCC), overall survival has improved, and patients are being treated continuously for increasingly long periods of time. This has raised challenges in the management of adverse events (AEs) associated with the six targeted agents approved in RCC-sorafenib, sunitinib, pazopanib, bevacizumab (in combination with interferon alpha), temsirolimus, and everolimus. Suggestions for monitoring and managing AEs have been published, but there are few consensus recommendations. In addition, there is a risk that patients will be subjected to multiple unnecessary investigations. In this review, we aimed to identify the level of supporting evidence for suggested AE management strategies to provide practical guidance on essential monitoring and management that should be undertaken when using targeted agents. Five databases were systematically searched for relevant English language articles (including American Society of Clinical Oncology abstracts) published between January 2007 and March 2011; European Society of Medical Oncology congress abstracts were hand searched. Strategies for AE management were summarized and categorized according to the level of recommendation. A total of 107 articles were identified that describe a large number of different investigations for monitoring AEs and interventions for AE management. We identify and summarize clear recommendations for the management of dermatologic, gastrointestinal, thyroid, cardiovascular, and other AEs, based predominantly on expert opinion. However, because the evidence for the suggested management strategies is largely anecdotal, there is a need for further systematic investigation of management strategies for AEs related to targeted therapies for RCC.
- Published
- 2012
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