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Complications of mammalian target of rapamycin inhibitor anticancer treatment among patients with tuberous sclerosis complex are common and occasionally life-threatening
Abstract
The aim of this study was to evaluate the most common adverse events (AEs) linked to everolimus therapy, a mammalian target of rapamycin (mTOR) inhibitor, in children and adolescents with tuberous sclerosis complex (TSC) hospitalized in one medical center. The study group included 18 patients with a diagnosis of subependymal giant cell astrocytoma or renal angiomyolipoma related to TSC. The median duration of therapy was 15 months. All clinical symptoms and laboratory abnormalities including complete blood count, fasting lipid profile, glucose level, and liver and kidney function tests were analyzed as potential AEs. The most common AEs of everolimus therapy were laboratory abnormalities (100% of patients) and infection complications (83 episodes in 15 patients). Infectious episodes of pharyngitis (67%), diarrhea (44%), stomatitis (39%), and bronchitis (39%) were the most common infections. They were mostly mild or moderate in severity (grade 1-2). In two cases, life-threatening conditions related to mTOR inhibitor treatment were encountered. The first was classified as grade 4 pleuropneumonia and Streptococcus pneumoniae sepsis, whereas the second was classified as death related to AE (grade 5) Escherichia coli sepsis. The most common laboratory abnormalities were hypercholesterolemia (13/18 patients - 72%) and hypertriglyceridemia (12/18 patients - 66%). Neutropenia (12/18 patents - 66%) and anemia (8/18 patients - 44%) were the most common hematologic toxicities. Everolimu…
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“Trelinska and colleagues observed hyperlipidemia in 66% of TSC patients taking high daily doses of everolimus for 15 months; hyperglycemia was observed in 22% of subjects 139.”
From Targeting the biology of aging with mTOR inhibitors (2023) · cites this paper as [139]
In the citing paper
“Chronic treatment of humans with high doses of rapalogs is also associated with deleterious metabolic consequences including hyperlipidemia, hypercholesterolemia, hypertriglyceridemia, insulin resistance and glucose intolerance 139–143.”
From Targeting the biology of aging with mTOR inhibitors (2023) · cites this paper as [139]
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Cited by
Sorted by citations
The mechanistic target of rapamycin: the grand conducTOR of metabolism and aging
Kennedy, B. K., & Lamming, D. W. (2016) · Cell Metabolism · doi:10.1016/j.cmet.2016.05.009 · Cited by 544
Targeting the biology of aging with mTOR inhibitors
Mannick, J. B., & Lamming, D. W. (2023) · Nature Aging · doi:10.1038/s43587-023-00416-y · Cited by 372
Lamming, D. W., Cummings, N. E., Rastelli, A. L., Gao, F., Cava, E., Bertozzi, B., Spelta, F., Pili, R., & Fontana, L. (2015) · Oncotarget · doi:10.18632/oncotarget.5180 · Cited by 69
Castagnola, E., Ruberto, E., & Guarino, A. (2016) · World Journal of Gastroenterology · doi:10.3748/wjg.v22.i25.5853 · Cited by 17
Metadata
- Authors
- Trelinska, J., Dachowska, I., Kotulska, K., Fendler, W., Jozwiak, S., & Mlynarski, W.
- Venue
- Anti-Cancer Drugs
- Published
- 2015-04
- Volume
- 26
- Issue
- 4
- Pages
- 437-442
- ISSN
- 0959-4973
- Cited by
- 60
- References
- 1
- Language
- en
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