Pancreatitis with vascular endothelial growth factor receptor tyrosine kinase inhibitors

Ghatalia, Pooja; Morgan, Charity J.; Choueiri, Toni K.; Rocha, Pedro; Naik, Gurudatta; Sonpavde, Guru

doi:10.1016/j.critrevonc.2014.11.008

Cited by 35 publications

(26 citation statements)

References 38 publications

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“…The activity of ponatinib against VEGFR may be another explanation for the adverse events. Previous studies have indicated that VEGFR inhibitors increase the risk of pancreatitis and treatment-associated mortality rates (21,22). As a result, compared with ponatinib and TKI258, AZD4547 may be safer for clinical use, as the specificity of AZD4547 eliminates the adverse events associated with VEGFR.…”

Section: Discussionmentioning

confidence: 99%

Activity of fibroblast growth factor receptor inhibitors TKI258, ponatinib and AZD4547 against TPR-FGFR1 fusion

Qiu

Feng

Shao

et al. 2017

Molecular Medicine Reports

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8p11 myeloproliferative syndrome (EMS) is a rare disease characterized by the constitutive activation of fibroblast growth factor receptor 1 (FGFR1). To date, four cases of EMS with the chromosomal translocation, t(1;8)(q25;p11.2), have been reported. In the present study, TPR-FGFR1-expressing Baf3 cells were established and confirmed by polymerase chain reaction. To identify the most promising drug for EMS, the activities and associated mechanism of three tyrosine kinase inhibitors (TKIs), TKI258, ponatinib and AZD4547, against TPR-FGFR1 were tested by MTT assay, flow cytometry and western blot. The data demonstrated that TPR-FGFR1 was localized in the cytoplasm, and was able to transform interleukin-3-dependent hematopoietic Baf3 cells into growth factor-independent cells. All of the three TKIs markedly inhibited the proliferation of TPR-FGFR1-expressing Baf3 cells, and the activation of FGFR1 and the downstream signaling molecules, extracellular signal-regulated kinase 1/2, phospholipiase Cγ and signal transducer and activator of transcription 5. AZD4547 was the most efficient drug, and TKI258 was the least. By contrast, no significant difference was found among the three drugs on their effect on cell apoptosis. Taken together, the data obtained in the present study suggested that AZD4547 had increased potency, compared with TKI258 and ponatinib, for the treatment of EMS.

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Section: Discussionmentioning

confidence: 99%

Activity of fibroblast growth factor receptor inhibitors TKI258, ponatinib and AZD4547 against TPR-FGFR1 fusion

Qiu

Feng

Shao

et al. 2017

Molecular Medicine Reports

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“…However, restarting of the drug must be carefully considered because pancreatic pseudocyst recurrence has been reported after resuming treatment with l -asparaginase 6. On the contrary, the relative risk of pancreatitis associated with multitargeted vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors such as sunitinib, sorafenib, pazopanib, axitinib, vandetanib, cabozantinib, ponatinib and regorafenib has been reported 7. Treatment with tyrosine kinase inhibitors can cause acute pancreatitis, although the development of pancreatic pseudocysts is rare.…”

Section: Discussionmentioning

confidence: 99%

Crizotinib-induced pancreatic pseudocyst: a novel adverse event

2015

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Crizotinib is a tyrosine kinase inhibitor that demonstrates a dramatic tumour response in patients with advanced non-small cell lung cancers harbouring anaplastic lymphoma kinase (ALK) rearrangement. The pancreatic cyst has never been reported in patients who received crizotinib, whereas crizotinib-induced renal cysts developed in 4% of patients who were enrolled in clinical trials. We present the case of a 54-year-old man who was diagnosed with non-small cell lung cancer harbouring ALK rearrangement. After the start of treatment with crizotinib, we accidentally encountered the pancreatic pseudocyst without abdominal symptom and elevated serum pancreatic enzymes. In this report, we describe a case of pancreatic pseudocyst that appeared after starting treatment with crizotinib and regressed after treatment withdrawal.

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“…A recent meta-analysis concluded that small-molecule VEGFR tyrosine kinase inhibitors were associated with the development of acute pancreatitis of varying severity when used during the treatment of a broad range of malignancies. This meta-analysis also demonstrated that there was no significant effect on the type of neoplasm or the development of all-grade and high-grade pancreatitis [7]. …”

Section: Discussionmentioning

confidence: 99%

Sorafenib-Induced Acute Pancreatitis in a Patient with Differentiated Thyroid Cancer

2018

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Background: Sorafenib is a tyrosine kinase inhibitor approved for the treatment of metastatic renal cell carcinoma, hepatocellular carcinoma, and recently for radioactive iodine (RAI)-refractory metastatic differentiated thyroid carcinoma (DTC). Several side effects have been described including alterations in amylase and lipase levels. Nonetheless, only a few cases of pancreatitis during renal carcinoma and hepatocellular carcinoma treatment have been described. Objective: To describe the first case report of sorafenib-induced acute pancreatitis during the treatment of thyroid carcinoma. Methods and Results: In a 60-year-old Latin woman with RAI-refractory papillary thyroid carcinoma, T4bN1bM1, sorafenib was indicated due to locally recurrent, metastatic, and progressive lung involvement without iodine uptake. Therapy was initiated (200 mg) every 8 h. Three days after starting the medication, abdominal pain, nausea, and emesis appeared. A blood test revealed elevated amylase (343 U/L RV: 28–100) and lipase (1,969 U/L RV: 23–300) levels, but no other findings, confirming acute mild pancreatitis. Hypertriglyceridemia, hypercalcemia, and alcohol and biliary etiologies were ruled out and sorafenib-acute pancreatitis was concluded. Two weeks later, sorafenib was resumed without recurrence. To date, this is the tenth sorafenib-related pancreatitis report and the first in a patient with RAI-refractory metastatic DTC. Conclusions: Sorafenib-acute pancreatitis may develop in patients with RAI-refractory thyroid cancer. This adverse event seems to be independent of the treatment duration and administered dose. Resuming the medication with an adjusted dose after pancreatitis resolution may be safe.

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Pancreatitis with vascular endothelial growth factor receptor tyrosine kinase inhibitors

Cited by 35 publications

References 38 publications

Activity of fibroblast growth factor receptor inhibitors TKI258, ponatinib and AZD4547 against TPR-FGFR1 fusion

Activity of fibroblast growth factor receptor inhibitors TKI258, ponatinib and AZD4547 against TPR-FGFR1 fusion

Crizotinib-induced pancreatic pseudocyst: a novel adverse event

Sorafenib-Induced Acute Pancreatitis in a Patient with Differentiated Thyroid Cancer

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