Hyponatraemia—SIADH in lung cancer diagnostic and treatment algorithms

Grohé, Christian; Berardi, Rossana; Burst, Volker

doi:10.1016/j.critrevonc.2015.04.005

Cited by 39 publications

(35 citation statements)

References 26 publications

(34 reference statements)

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“…SIADH can be due to nonosmotic release of antidiuretic hormone (ADH) from the tumor itself or due to the effect of drugs used in the treatment and palliation of cancer, like vincristine, vinblastine, and cyclophosphamide, among others 11. Some of these agents like cyclophosphamide can potentiate the actions of ADH at the renal tubular level.…”

Section: Hyponatremia In Cancer Patientsmentioning

confidence: 99%

“…Some of these agents like cyclophosphamide can potentiate the actions of ADH at the renal tubular level. Similarly, opioid analgesics used for pain control in cancer patients, antidepressants used in treatment of depression in cancer patients (including tricyclics and selective serotonin reuptake inhibitors), and phenothiazines used as antiemetic agents can all stimulate ADH secretion 11. Cancer patients can develop nausea and vomiting as part of the disease or following chemotherapy which in turn can cause inappropriate ADH secretion leading to hyponatremia.…”

Section: Hyponatremia In Cancer Patientsmentioning

confidence: 99%

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Role of tolvaptan in the management of hyponatremia in patients with lung and other cancers: current data and future perspectives

Thajudeen

Salahudeen

2016

CMAR

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Hyponatremia is the most frequently observed electrolyte abnormality in clinical practice, and its frequency is almost double in hospitalized cancer patients. As a subset of cancer, hyponatremia is quite common in lung cancer patients, and it is often coupled with the diagnosis of syndrome of inappropriate antidiuretic hormone secretion. The presence of hyponatremia is consequential in that its presence adversely affects cancer patients’ prognosis and outcomes. Limited data suggest that correcting hyponatremia in lung cancer patients can increase response to anticancer treatment, may help reduce length of hospital stay and cost, and reduce morbidity and mortality. The type of treatment for hyponatremia depends on several factors; the key factors are the duration and severity of neurological symptoms of hyponatremia and the status of extracellular volume. When hyponatremia is caused by syndrome of inappropriate antidiuretic hormone, hypertonic saline is indicated for acute symptomatic cases, whereas fluid restriction is recommended in chronic asymptomatic hyponatremia. The latter allows a slower rate of correction, thus avoiding the dreaded complication of osmotic demyelination syndrome. Fluid restriction is, however, insufficient or impractical, and often the use of pharmacological therapy such as antidiuretic hormone receptor antagonists becomes necessary. Availability of these antagonists as an effective treatment in the management of hyponatremia has been a major breakthrough, and furthermore, its clinical or investigational use in cancer-related hyponatremia may offer a potential opportunity to gain further insights into the prognostic impact of hyponatremia correction on cancer patients’ outcomes. Tolvaptan is a prototype of ADH receptor antagonists that acts at renal tubular levels to increase free water excretion without inducing major systemic electrolyte abnormalities such as hypokalemia or alkalosis. The aim of this paper is to provide a brief review while focusing on cancer hyponatremia; (1) of the epidemiology of hyponatremia and its pathophysiology and diagnostic approaches and (2) of the pharmacokinetics of tolvaptan and its clinical efficacy, safety, and compliance.

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Section: Hyponatremia In Cancer Patientsmentioning

confidence: 99%

Section: Hyponatremia In Cancer Patientsmentioning

confidence: 99%

Role of tolvaptan in the management of hyponatremia in patients with lung and other cancers: current data and future perspectives

Thajudeen

Salahudeen

2016

CMAR

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“…In fact, hyponatremia is quite common in malignant solid tumors beyond SIADH (up to 25% of all patients). It is used as a prognostic and predictive value and is associated with high morbidity rates; its early diagnosis and treatment significantly improves the patients' prognosis (Schutz et al, 2014;Grohé and Berardi, 2015;Balachandran et al, 2015). This correlation suggests that systemic hypotonicity / hyponatremia increases carcinoma incidence and aggressiveness.…”

Section: The Cooperation Between Atp1b1a and Lgl2mentioning

confidence: 99%

“…A major human condition that leads to systemic hypotonicity in conjunction with reduced Na levels (hypotonic or hypoosmolar hyponatremia) is increased nephric water re-absorption caused by ADH (antidiuretic hormone) hyperactivity. In SIADH (Syndrome of inappropriate antidiuretic hormone secretion), this is usually linked to carcinogenesis and results from ectopic ADH production by the tumors, which in general are rather aggressive (Ellison and Berl, 2007;Grohé and Berardi, 2015). In fact, hyponatremia is quite common in malignant solid tumors beyond SIADH (up to 25% of all patients).…”

Section: The Cooperation Between Atp1b1a and Lgl2mentioning

confidence: 99%

“…Such stress might occur, for instance, during injuries of the lung or the esophagus (Ribeiro et al, 1996;Islami et al, 2009;Goldkorn and Filosto, 2010;Maret-Ouda et al, 2016), when epithelial cells become exposed to the airway surface fluid (Joris and Quinton, 1993) or to saliva (Edgar, 1992), respectively, both of which are hypotonic compared to the internal milieu. In this light, and in light of the data presented in this work, it makes sense to include treatments that target osmotic conditions in therapies against certain carcinoma types (Balachandran et al, 2015;Grohé and Berardi, 2015). Furthermore, lavages with distilled water during cancer surgery (Iitaka et al, 2012), or hypotonic approaches to improve the uptake of chemotherapeutics by tumor cells (Stephen et al, 1990), should be used with caution.…”

Section: The Cooperation Between Atp1b1a and Lgl2mentioning

confidence: 99%

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509 Tumor suppression in basal keratinocytes via dual non-cell-autonomous functions of a Na,K-ATPase beta subunit

Hatzold

Beleggia

Herzig

et al. 2016

Journal of Investigative Dermatology

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The molecular pathways underlying tumor suppression are incompletely understood.Here, we identify cooperative non-cell-autonomous functions of a single gene that together provide a novel mechanism of tumor suppression in basal keratinocytes of zebrafish embryos. A loss-of-function mutation in atp1b1a, encoding the beta subunit of a Na,K-ATPase pump, causes edema and epidermal malignancy. Strikingly, basal cell carcinogenesis only occurs when Atp1b1a function is compromised in both the overlying periderm (resulting in compromised epithelial polarity and adhesiveness) and in kidney and heart (resulting in hypotonic stress). Blockade of the ensuing PI3K-AKT-mTORC1-NFkB-MMP9 pathway activation in basal cells, as well as systemic isotonicity, prevents malignant transformation. Our results identify hypotonic stress as a (previously unrecognized) contributor to tumor development and establish a novel paradigm of tumor suppression.

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The syndrome of inappropriate antidiuretic hormone associated with nasal and paranasal malignant tumors

Dang,

Zhang,

Zhao

et al. 2024

Eur Arch Otorhinolaryngol

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Purpose To investigate the clinical characteristics of the syndrome of inappropriate antidiuretic hormone (SIADH) associated with nasal and paranasal malignant tumors. Methods Patients with locally advanced or recurrence/metastatic malignant tumors of the nasal and paranasal sinuses were included. The SIADH was diagnosed according to the diagnostic criteria. The clinical characteristics of SIADH patients were retrospectively analyzed. Results Six patients (6/188, 3.2%) met the diagnostic criteria of SIADH, including four olfactory neuroblastoma (4/26, 15.4%), one neuroendocrine carcinoma (1/9, 11.1%), and one squamous cell carcinoma (1/63, 1.6%). Five patients (83.3%) had severe hyponatremia; however, the hyponatremia could be improved by fluid restriction or tolvaptan. Three patients' SIADH were recovered during the chemotherapy and the other three were recovered after the surgery. Conclusion The incidence of SIADH associated with nasal and paranasal malignant tumors is relatively more common in olfactory neuroblastoma and neuroendocrine carcinoma. The hyponatremia caused by SIADH may be corrected by fluid restriction or tolvaptan, and the SIADH may be recovered through anti-tumor therapy.

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Hyponatraemia—SIADH in lung cancer diagnostic and treatment algorithms

Cited by 39 publications

References 26 publications

Role of tolvaptan in the management of hyponatremia in patients with lung and other cancers: current data and future perspectives

Role of tolvaptan in the management of hyponatremia in patients with lung and other cancers: current data and future perspectives

509 Tumor suppression in basal keratinocytes via dual non-cell-autonomous functions of a Na,K-ATPase beta subunit

The syndrome of inappropriate antidiuretic hormone associated with nasal and paranasal malignant tumors

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