The Experts below are selected from a list of 39 Experts worldwide ranked by ideXlab platform
Peter Reichardt - One of the best experts on this subject based on the ideXlab platform.
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practical management of tyrosine kinase inhibitor associated side effects in gist
Cancer Treatment Reviews, 2011Co-Authors: Heikki Joensuu, Jonathan C Trent, Peter ReichardtAbstract:Summary Patients diagnosed with advanced gastrointestinal stromal tumor (GIST) are currently treated with oral tyrosine kinase inhibitors (TKIs). Imatinib mesylate is the standard first-line treatment, and sunitinib malate is administered second-line for patients who are intolerant or progress on imatinib. Imatinib has recently been approved for adjuvant treatment of GIST patients who have a significant risk for relapse. In both the metastatic and adjuvant settings, patients may be on these TKIs for many years. Low plasma imatinib levels have been reported to be associated with a short median time to progression of advanced GIST, stressing the importance of maintaining optimal drug levels. We summarize management of the most frequent and clinically significant adverse effects of imatinib and sunitinib in the treatment of GIST in the context of current guidelines, published literature, and the experience of three large GIST referral centers. The adverse events reviewed include nausea and vomiting, diarrhea, skin rash, musculoskeletal complaints, fatigue, hemorrhage, edema, hand–foot skin reaction, skin and Hair Discoloration, mucositis, hypertension, cardiac toxicity, hypothyroidism, liver transaminase changes, and hematological toxicity of imatinib and sunitinib. Potential drug–drug interactions with each respective agent are also discussed. With prudent use of supportive care measures, many side effects can be managed without dose reduction or interruption of treatment. On the other hand, individualized tailoring of the dose is often required to manage severe toxicity, such as painful hand–foot skin reactions, fatigue, hepatotoxicity, or cardiac toxicity. Management of many TKI-related adverse effects require further evaluation in prospective clinical trials.
Giorgio Massimini - One of the best experts on this subject based on the ideXlab platform.
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safety pharmacokinetic and antitumor activity of su11248 a novel oral multitarget tyrosine kinase inhibitor in patients with cancer
Journal of Clinical Oncology, 2006Co-Authors: Sandrine Faivre, Catherine Delbaldo, Karina Vera, Stephanie Lozahic, Samuel E Deprimo, Nicoletta Brega, Nathalie Lassau, Carlo L. Bello, Caroline Robert, Giorgio MassiminiAbstract:Purpose To establish the safety, pharmacokinetics, and recommended dose of sunitinib, a novel oral multitargeting tyrosine kinase inhibitor with antiangiogenic and antitumor properties, in patients with advanced malignancies. Patients and Methods Sunitinib was given orally for 4 weeks every 6 weeks. Results Twenty-eight patients received doses ranging from 15 to 59 mg/m2 (ranging from 50 mg every other day to 150 mg/d). Dose-limiting toxicities reported at the maximum-tolerated doses ≥ 75 mg/d were reversible grade 3 fatigue, grade 3 hypertension, and grade 2 bullous skin toxicity. Therefore, the recommended dose was 50 mg/d. At this dose, the main adverse effects were sore mouth, edema, and thrombocytopenia. Hair Discoloration and yellow coloration of the skin were observed at doses ≥ 50 mg/d. Pharmacokinetic data indicate that potentially active target plasma concentrations ≥ 50 ng/mL can be achieved with moderate interpatient variability and a long half-life compatible with a single daily dosing. Six o...
Heikki Joensuu - One of the best experts on this subject based on the ideXlab platform.
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practical management of tyrosine kinase inhibitor associated side effects in gist
Cancer Treatment Reviews, 2011Co-Authors: Heikki Joensuu, Jonathan C Trent, Peter ReichardtAbstract:Summary Patients diagnosed with advanced gastrointestinal stromal tumor (GIST) are currently treated with oral tyrosine kinase inhibitors (TKIs). Imatinib mesylate is the standard first-line treatment, and sunitinib malate is administered second-line for patients who are intolerant or progress on imatinib. Imatinib has recently been approved for adjuvant treatment of GIST patients who have a significant risk for relapse. In both the metastatic and adjuvant settings, patients may be on these TKIs for many years. Low plasma imatinib levels have been reported to be associated with a short median time to progression of advanced GIST, stressing the importance of maintaining optimal drug levels. We summarize management of the most frequent and clinically significant adverse effects of imatinib and sunitinib in the treatment of GIST in the context of current guidelines, published literature, and the experience of three large GIST referral centers. The adverse events reviewed include nausea and vomiting, diarrhea, skin rash, musculoskeletal complaints, fatigue, hemorrhage, edema, hand–foot skin reaction, skin and Hair Discoloration, mucositis, hypertension, cardiac toxicity, hypothyroidism, liver transaminase changes, and hematological toxicity of imatinib and sunitinib. Potential drug–drug interactions with each respective agent are also discussed. With prudent use of supportive care measures, many side effects can be managed without dose reduction or interruption of treatment. On the other hand, individualized tailoring of the dose is often required to manage severe toxicity, such as painful hand–foot skin reactions, fatigue, hepatotoxicity, or cardiac toxicity. Management of many TKI-related adverse effects require further evaluation in prospective clinical trials.
Sandrine Faivre - One of the best experts on this subject based on the ideXlab platform.
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safety pharmacokinetic and antitumor activity of su11248 a novel oral multitarget tyrosine kinase inhibitor in patients with cancer
Journal of Clinical Oncology, 2006Co-Authors: Sandrine Faivre, Catherine Delbaldo, Karina Vera, Stephanie Lozahic, Samuel E Deprimo, Nicoletta Brega, Nathalie Lassau, Carlo L. Bello, Caroline Robert, Giorgio MassiminiAbstract:Purpose To establish the safety, pharmacokinetics, and recommended dose of sunitinib, a novel oral multitargeting tyrosine kinase inhibitor with antiangiogenic and antitumor properties, in patients with advanced malignancies. Patients and Methods Sunitinib was given orally for 4 weeks every 6 weeks. Results Twenty-eight patients received doses ranging from 15 to 59 mg/m2 (ranging from 50 mg every other day to 150 mg/d). Dose-limiting toxicities reported at the maximum-tolerated doses ≥ 75 mg/d were reversible grade 3 fatigue, grade 3 hypertension, and grade 2 bullous skin toxicity. Therefore, the recommended dose was 50 mg/d. At this dose, the main adverse effects were sore mouth, edema, and thrombocytopenia. Hair Discoloration and yellow coloration of the skin were observed at doses ≥ 50 mg/d. Pharmacokinetic data indicate that potentially active target plasma concentrations ≥ 50 ng/mL can be achieved with moderate interpatient variability and a long half-life compatible with a single daily dosing. Six o...
Jonathan C Trent - One of the best experts on this subject based on the ideXlab platform.
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practical management of tyrosine kinase inhibitor associated side effects in gist
Cancer Treatment Reviews, 2011Co-Authors: Heikki Joensuu, Jonathan C Trent, Peter ReichardtAbstract:Summary Patients diagnosed with advanced gastrointestinal stromal tumor (GIST) are currently treated with oral tyrosine kinase inhibitors (TKIs). Imatinib mesylate is the standard first-line treatment, and sunitinib malate is administered second-line for patients who are intolerant or progress on imatinib. Imatinib has recently been approved for adjuvant treatment of GIST patients who have a significant risk for relapse. In both the metastatic and adjuvant settings, patients may be on these TKIs for many years. Low plasma imatinib levels have been reported to be associated with a short median time to progression of advanced GIST, stressing the importance of maintaining optimal drug levels. We summarize management of the most frequent and clinically significant adverse effects of imatinib and sunitinib in the treatment of GIST in the context of current guidelines, published literature, and the experience of three large GIST referral centers. The adverse events reviewed include nausea and vomiting, diarrhea, skin rash, musculoskeletal complaints, fatigue, hemorrhage, edema, hand–foot skin reaction, skin and Hair Discoloration, mucositis, hypertension, cardiac toxicity, hypothyroidism, liver transaminase changes, and hematological toxicity of imatinib and sunitinib. Potential drug–drug interactions with each respective agent are also discussed. With prudent use of supportive care measures, many side effects can be managed without dose reduction or interruption of treatment. On the other hand, individualized tailoring of the dose is often required to manage severe toxicity, such as painful hand–foot skin reactions, fatigue, hepatotoxicity, or cardiac toxicity. Management of many TKI-related adverse effects require further evaluation in prospective clinical trials.
