Understanding and managing toxicities of vascular endothelial growth factor (VEGF) inhibitors

Schmidinger, Manuela

doi:10.1016/j.ejcsup.2013.07.016

Cited by 103 publications

(78 citation statements)

References 195 publications

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“…Close monitoring with frequent radiographic evaluations when patients present with an increased risk is the main prophylactic recommendation . Treatment discontinuation is recommended when GI perforation occurs .…”

Section: Resultsmentioning

confidence: 99%

Management of Adverse Events Associated with Cabozantinib Therapy in Renal Cell Carcinoma

Schmidinger

Danesi

2017

The Oncologist

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Cabozantinib leads to improved survival outcomes in renal cell carcinoma patients compared with everolimus. However, management of the adverse event profile is crucial to achieve optimum adherence and outcomes with the use of cabozantinib. This review aims to provide appropriate guidance that will minimize the impact of adverse events and help to maximize the utility of this agent in patients with advanced renal cell carcinoma.

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Section: Resultsmentioning

confidence: 99%

Management of Adverse Events Associated with Cabozantinib Therapy in Renal Cell Carcinoma

Schmidinger

Danesi

2017

The Oncologist

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“…The underlying mechanism has not been elucidated. VEGF inhibitors may cause changes in the bowel mucosa, leading to diarrhea . Patients are advised to avoid caffeine and lactose‐containing products during anlotinib treatment.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism of VEGF inhibitors‐induced proteinuria may include inhibition of VEGF on podocytes, glomerular endothelial cell detachment and hypertrophy, and glomerular thrombotic microangiopathy . Patients with proteinuria ≥2.0 g/L should withhold anlotinib until proteinuria <1.0 g/L, then resume at a reduced dose.…”

Section: Discussionmentioning

confidence: 99%

Management of anlotinib‐related adverse events in patients with advanced non‐small cell lung cancer: Experiences in ALTER‐0303

Zhang

Wang

et al. 2019

Thoracic Cancer

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Background Anlotinib is an oral tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor, fibroblast growth factor receptor, platelet‐derived growth factor receptor, and stem cell factor receptor (c‐Kit). In the phase III ALTER‐0303 trial (Clinical Trial Registry ID: NCT 02388919), anlotinib significantly improved overall survival versus placebo in advanced non‐small cell lung cancer patients who had received at least two previous chemotherapy and epidermal growth factor receptor/anaplastic lymphoma kinase targeted therapy regimens. This study summarized adverse event management in this trial. Methods Patients were randomized (2:1) to anlotinib or placebo up to progression or intolerable toxicity. Adverse events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0 and managed by investigators. Key strategies for preventing and managing the most common adverse events included patient education, supportive care, and dose modification. Results Between February 2015 and August 2016, 294 patients received anlotinib. A total of 170 (57.8%) patients received antihypertensive medications for hypertension, 53 (18.0%) patients received levothyroxine for hypothyroidism, 24 (8.2%) patients received fibrates for hypertriglyceridemia, 11 (3.7%) patients took cortisone cream for hand‐foot syndrome, and 38 (12.9%) patients received anti‐diarrheal medications for diarrhea. Dose reduction and drug discontinuation were required in 24 (8.16%) and 31 (10.54%) patients in the anlotinib group, respectively. Conclusion Anlotinb‐related adverse events could be controlled by patient education, prophylactic measures, early and active intervention, and dose modification.

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“…This kind of rash can be caused from VEGFRIs, that is sorafenib, sunitinib, and ponatinib. 37 Xerosis has been referred, which is usually treated with topical antihistamines, urea and Laureth-9 containing creams. 14 Alteration in the color of hair (gray hair) has been observed in the late phase of the therapy with sunitinib due to the inhibition of tyrosine kinase c-Kit, which is responsible for the migration of melanocytes to the hair follicle.…”

Section: Vegfris and Pdgfrismentioning

confidence: 99%

“…Maculopapular or morbilliform rash is defined as a disorder characterized by the appearance of macules (flat) and papules (elevated) frequently affecting the upper trunk, spreading centripetally and associated with pruritus. This kind of rash can be caused from VEGFRIs, that is sorafenib, sunitinib, and ponatinib …”

Section: Introductionmentioning

confidence: 99%

Targeted therapy in oncology patients and skin: Pharmaceutical and dermocosmetic management

Varvaresou

Iakovou

Mellou

et al. 2019

J of Cosmetic Dermatology

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Background Numerous oncology patients who receive targeted therapy suffer from the skin adverse effects induced. Novel agents, that is tyrosine kinase inhibitors and RAS‐RAF‐MEK‐ERK pathway, have given good results in patient survival while decreasing the systemic toxicities in comparison to conventional cytotoxic chemotherapy, but are also related to skin adverse effects. Aims In this article, we highlighted the importance of specific pharmaceutical and dermocosmetic management of the untoward events of targeted therapy. Conclusion The combination of Oncodermatology, Psychodermatology, Cosmetic Dermatology, Cosmetic Science, Dermatopharmacology and Aesthetic Science can offer a lot for the prevention or early relief of the cutaneous adverse effects in oncology patients receiving targeted therapy.

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Understanding and managing toxicities of vascular endothelial growth factor (VEGF) inhibitors

Cited by 103 publications

References 195 publications

Management of Adverse Events Associated with Cabozantinib Therapy in Renal Cell Carcinoma

Management of Adverse Events Associated with Cabozantinib Therapy in Renal Cell Carcinoma

Management of anlotinib‐related adverse events in patients with advanced non‐small cell lung cancer: Experiences in ALTER‐0303

Targeted therapy in oncology patients and skin: Pharmaceutical and dermocosmetic management

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