Reversible Posterior Leukoencephalopathy Syndrome Developing After Restart of Sunitinib Therapy for Metastatic Renal Cell Carcinoma

Fukui, Shinji; Toyoshima, Yuta; Inoue, Takeshi; Kagebayashi, Yoriaki; Samma, Shoji

doi:10.1155/2016/6852951

Cited by 9 publications

(6 citation statements)

References 16 publications

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“…All of these VEGF receptor antagonists can potentially cause RPLS. While cases of RPLS due to renal carcinoma targeted therapies are rare, reports involving sunitinib have been most frequent [5][6][7][8][9][10][11][12][13]. We report herein the second case, to our knowledge with RPLS induced by axitinib [13].…”

Section: Discussionmentioning

confidence: 80%

Axitinib-induced reversible posterior leukoencephalopathy syndrome in a patient with metastatic renal cell carcinoma

et al. 2017

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A 61-year-old woman with metastatic renal carcinoma was treated with axitinib as a second-line tyrosine kinase inhibitor. Thirteen days after the treatment, the patient developed reversible posterior leukoencephalopathy syndrome (RPLS). Her symptoms and imaging findings resolved after withdrawal of axitinib, blood pressure control, and administration of glycerin and levetiracetam. RPLS should be kept in mind as a possible rare adverse event after axitinib administration.

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Section: Discussionmentioning

confidence: 80%

Axitinib-induced reversible posterior leukoencephalopathy syndrome in a patient with metastatic renal cell carcinoma

et al. 2017

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“…parieto-occipital and cerebellar lobes, dorsal brain stem, and left thalamus) [16,17]. The diffusion-weighted imaging on MRI shows also the elevation of apparent diffusion coefficient mapping [14]. This syndrome has been described related to different clinical circumstances, such as uncontrolled hypertension, eclampsia, collagen vascular disorders and Guillan-Barré syndrome, and drugs, especially immunosuppressive agents and cytotoxic drugs such as cyclosporine, tacrolimus, cisplatin, cytarabine, antiangiogenic agents, and tyrosine kinase inhibitors [15,18].…”

Section: Discussionmentioning

confidence: 96%

“…Nevertheless, the exact pathogenesis of PRES remains unclear but it is most likely due to the development of hypertension and endothelial dysfunction, which are the direct effect of anti-VEGFR agents, with subsequent damage of the blood-brain barrier, impaired cerebrovascular autoregulation, hyperperfusion, and vasogenic edema [14,17,[19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

“…The development of PRES usually occurs in the first months of drug administration or reintroduction, but late-onset is also reported [13,14]. When quickly recognized and managed, the symptoms and the radiological alterations usually are almost always reversible with complete or near-complete resolution lasting from several days to months.…”

Section: Discussionmentioning

confidence: 99%

“…We described a rare case of a metastatic sarcomatoid MTSCC which responded to first-line vascular endothelial growth factor receptor-tyrosine kinase inhibitor (VEGFR-TKI) developing also a rare adverse event, the posterior reversible encephalopathy syndrome (PRES). PRES is a very rare side effect of anti-VEGFR drugs [13,14] and consists in acute neurological disorders characterized by subcortical vasogenic edema usually affecting the posterior portions of the cerebral hemispheres, although other areas may be affected [14]. Moreover, this rare histology of renal carcinoma experienced clinical benefit and long-term response to second-line immunotherapy.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Rare anti-VEGFR therapy-induced toxicity and long-term response to immunotherapy in a rare non-clear cell renal cell carcinoma patient

Catalano¹,

Rebuzzi²,

Murianni³

et al. 2021

Anti-Cancer Drugs

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Advanced non-clear cell renal cell carcinoma (nccRCC) has a poor prognosis and clinical data on the therapeutic options currently available, including immunotherapy, are generally limited highlighting an unmet clinical need. Moreover, the onset of rare adverse events raises the need of a better therapeutic management of limited treatment options. We report the clinical case of a 63-yearold man with the diagnosis of metastatic mucinous tubular and spindle cell carcinoma, a rare nccRCC, with sarcomatoid differentiation who developed two episodes of posterior reversible encephalopathy syndrome (PRES) to first-line sunitinib. It appeared after 5 months the start of the targeted therapy and reappeared at the reintroduction of the therapy. PRES is a rare and unusual adverse event to anti-vascular endothelial growth factor receptor (VEGFR) therapies, which is characterized by acute neurological disorders along with typical changes on neurological imaging, especially MRI. Moreover, this rare histotype of RCC experienced a long-term response to immunotherapy which is lasting more than 2 years. This clinical case is interesting for its rarity as a rare neurological adverse event developed twice in a rare type of RCC which also experienced an unusual longterm benefit to immunotherapy. Anti-Cancer Drugs 33: e724-e729

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Neuro-ophthalmic complications of modern anti-cancer drugs

Oskam,

Danesh-Meyer

2024

Graefes Arch Clin Exp Ophthalmol

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Purpose Targeted cancer therapies have been responsible for a dramatic shift in treatment strategies for cancer, and the number of drugs, classes, and indications are continually growing. Neuro-ophthalmic complications of these medications are an uncommon but important subset of adverse events which profoundly impact vision. This review aims to collate studies and reports of known neuro-ophthalmic complications of targeted therapies and describe their management. Methods The anti-cancer drugs included in the review were any drugs targeting specific molecules involved in the cancer disease process. PubMed, EMBASE, and Web of Science were searched using the generic names of each drug and keywords of neuro-ophthalmic conditions. The prescribing information published by the US Food and Drug Administration (FDA) for each drug was also reviewed. Results Several classes of targeted anti-cancer drugs were found to cause neuro-ophthalmic adverse effects. Immune checkpoint inhibitors are responsible for a raft of immune-related adverse events such as optic neuritis, ischemic optic neuropathy, PRES, and myasthenia gravis. Therapies with anti-VEGF activity can provoke posterior reversible leukoencephalopathy, which commonly presents with visual loss and can be fatal if not treated promptly. Inhibitors of BCR-ABL1, VEGF, ALK, and proteasomes have all been linked to optic nerve disorders which can have debilitating consequences for vision. Conclusion The neuro-ophthalmic complications of modern anti-cancer drugs can limit or necessitate the withdrawal of these life-prolonging medications. Ophthalmologists should be alert for neuro-ophthalmic complications in these medications to facilitate prompt diagnosis and treatment and reduce the risk of severe and permanent consequences.

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Reversible Posterior Leukoencephalopathy Syndrome Developing After Restart of Sunitinib Therapy for Metastatic Renal Cell Carcinoma

Cited by 9 publications

References 16 publications

Axitinib-induced reversible posterior leukoencephalopathy syndrome in a patient with metastatic renal cell carcinoma

Axitinib-induced reversible posterior leukoencephalopathy syndrome in a patient with metastatic renal cell carcinoma

Rare anti-VEGFR therapy-induced toxicity and long-term response to immunotherapy in a rare non-clear cell renal cell carcinoma patient

Neuro-ophthalmic complications of modern anti-cancer drugs

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