Adverse event management in patients with advanced cancer receiving oral everolimus

Focus on breast cancer

M. Aapro, F. Andre, K. Blackwell, E. Calvo, Mohammad Jahanzeb, K. Papazisis, C. Porta, K. Pritchard, A. Ravaud

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Background: Everolimus, an orally administered rapamycin analogue, inhibits the mammalian target of rapamycin (mTOR), a highly conserved intracellular serine-threonine kinase that is a central node in a network of signaling pathways controlling cellular metabolism, growth, survival, proliferation, angiogenesis, and immune function. Everolimus has demonstrated substantial clinical benefit in randomized, controlled, phase III studies leading to approval for the treatment of advanced renal cell carcinoma,advanced neuroendocrine tumors of pancreatic origin, renal angiomyolipoma and subependymalgiant-cell astrocytoma associated with tuberous sclerosis complex, as well as advanced hormone-receptorpositive (HR+) and human epidermal growth factor receptor-negative advanced breast cancer. Materials and methods: We discuss clinically relevant everolimus-related adverse events from the phase III studies, including stomatitis,noninfectious pneumonitis,rash, selected metabolic abnormalities, and infections,with focus on appropriate clinical management of these events and specific considerations in patients with breast cancer.Results: The majority of adverse events experienced during everolimus therapy are of mild to moderate severity. The safety profile and protocols for toxicity management are well established. The class-effect adverse event profile observed with everolimus plus endocrine therapy in breast cancer is (as expected) distinct from that of endocrine therapy alone,but is similar to that observed with everolimus in other solid tumors. Information gained from the experience in other carcinomas on prompt diagnosis and treatments to optimize drug exposure,treatment outcomes,and patients' quality of life also applies to the patient population with advanced breast cancer.Conclusions: As with all orally administered agents, education of both physicians and patients in the management of adverse events for patients receiving everolimus is critical to achieving optimal exposure and clinical benefit.Active monitoring for early identification of everolimus-related adverse events combined with aggressive and appropriate intervention should lead to a reduction in the severity and duration of the event.

Original languageEnglish
Article numbermdu021
Pages (from-to)763-773
Number of pages11
JournalAnnals of Oncology
Volume25
Issue number4
DOIs
StatePublished - Jan 1 2014

Fingerprint

Mouth Neoplasms
Breast Neoplasms
Sirolimus
Therapeutics
Angiomyolipoma
Stomatitis
Tuberous Sclerosis
Neuroendocrine Tumors
Everolimus
Protein-Serine-Threonine Kinases
Astrocytoma
Exanthema
Renal Cell Carcinoma
Epidermal Growth Factor Receptor
Pneumonia
Quality of Life
Hormones
Carcinoma
Physicians
Kidney

Keywords

  • Everolimus
  • Infections
  • Metabolic abnormality
  • Pneumonitis
  • Rash
  • Stomatitis

ASJC Scopus subject areas

  • Oncology
  • Hematology
  • Medicine(all)

Cite this

Adverse event management in patients with advanced cancer receiving oral everolimus : Focus on breast cancer. / Aapro, M.; Andre, F.; Blackwell, K.; Calvo, E.; Jahanzeb, Mohammad; Papazisis, K.; Porta, C.; Pritchard, K.; Ravaud, A.

In: Annals of Oncology, Vol. 25, No. 4, mdu021, 01.01.2014, p. 763-773.

Research output: Contribution to journalArticle

Aapro, M, Andre, F, Blackwell, K, Calvo, E, Jahanzeb, M, Papazisis, K, Porta, C, Pritchard, K & Ravaud, A 2014, 'Adverse event management in patients with advanced cancer receiving oral everolimus: Focus on breast cancer', Annals of Oncology, vol. 25, no. 4, mdu021, pp. 763-773. https://doi.org/10.1093/annonc/mdu021
Aapro, M. ; Andre, F. ; Blackwell, K. ; Calvo, E. ; Jahanzeb, Mohammad ; Papazisis, K. ; Porta, C. ; Pritchard, K. ; Ravaud, A. / Adverse event management in patients with advanced cancer receiving oral everolimus : Focus on breast cancer. In: Annals of Oncology. 2014 ; Vol. 25, No. 4. pp. 763-773.
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AU - Andre, F.

AU - Blackwell, K.

AU - Calvo, E.

AU - Jahanzeb, Mohammad

AU - Papazisis, K.

AU - Porta, C.

AU - Pritchard, K.

AU - Ravaud, A.

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