Rare incidence of tumor lysis syndrome in metastatic prostate cancer following treatment with docetaxel

Abstract

Tumor lysis syndrome is a serious and sometimes lethal complication of cancer treatment that is comprised of a set of metabolic disturbances along with clinical manifestations. Initiating chemotherapy in bulky, rapidly proliferating tumors causes rapid cell turnover that in turn releases metabolites into circulation that give rise to metabolic derangements that can be dangerous. This syndrome is usually seen in high-grade hematological malignancies. Less commonly, tumor lysis syndrome can present in solid tumors and even rarely in genitourinary tumors. In this report, the authors describe a specific case of tumor lysis syndrome in a patient with metastatic prostate cancer following treatment with docetaxel.

Spontaneous Tumor Lysis Syndrome as Presenting Sign of Metastatic Prostate Cancer

“…In our review of the literature, we found nine cases of TLS occurring in patients with prostate cancer [2-10]. The majority of these cases involved the development of TLS after initiation of cancer-directed therapy [2-5, 8, 9]. Specifically, there were three cases of TLS after cytotoxic chemotherapy with either docetaxel or paclitaxel and two cases after androgen deprivation therapy (ADT), both with and without radiation therapy [2-5, 8].…”

“…The majority of these cases involved the development of TLS after initiation of cancer-directed therapy [2-5, 8, 9]. Specifically, there were three cases of TLS after cytotoxic chemotherapy with either docetaxel or paclitaxel and two cases after androgen deprivation therapy (ADT), both with and without radiation therapy [2-5, 8]. There was also one documented case of TLS after radiation therapy alone [9].…”

“…All patients described died prior to publication. Specifically, patients who developed TLS secondary to treatment died within 40 hours to two months of therapy initiation, with the majority expiring within 10 days [2-5, 8, 9]. Those patients who developed spontaneous TLS died within six weeks of TLS recognition [6, 7, 10].…”

“…Teaching points extracted from prior case reports include recognition and prevention of TLS in patients with bulky, aggressive metastatic disease despite the rarity of its occurrence in prostate cancer [2, 6-8]. This can be achieved by checking TLS labs, especially LDH and urate, prior to the initiation of cancer-directed therapy.…”

Tumor lysis syndrome associated with docetaxel and carboplatin in a case with recurrent endometrial cancer

“…Our case was similar in that there was recurrence with multiple metastasis and a regimen containing chemotherapeutic agents (platinum and taxane) was used. TLS associated with docetaxel has also been reported in only three cases: two patients with multiple metastatic prostate cancer ( Bhardwaj and Varma, 2017 ; Sorscher, 2004 ) and a patient with non-small-cell lung cancer ( Ajzensztejn et al, 2006 ).…”