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Fatigue most common AE yet least treated in patients taking tyrosine kinase inhibitors

09 Nov 2018

There are mostly nonserious adverse events (AEs) of special interest in patients taking tyrosine kinase inhibitors to treat metastatic renal cell carcinoma, of which more than half have received pharmacologic or nonpharmacologic treatment, a recent study has shown.

Additionally, the most common yet least frequently treated AE of special interest is fatigue, and few patients have received prophylaxis or nonpharmacologic treatment.

Tyrosine kinase inhibitors prescribed in 220 charts from 27 centres were the following: sunitinib (55 percent), pazopanib (27 percent), axitinib (9 percent) and sorafenib (8 percent). A total of 376 AEs of special interest were recorded during the study period, of which 13 percent were serious.

The most common AE was fatigue (62 percent of patients), followed by hypertension (37 percent), diarrhoea (30 percent), stomatitis/mycositis (29 percent) and hand-foot syndrome (12 percent). More than half of AEs of special interest (56 percent) were resolved or resolving. Fifteen percent of patients discontinued treatment due to AEs of special interest.

Prophylaxis was rarely provided. On the other hand, 59 percent of patients received treatment for AEs of special interest, 27 percent received tyrosine kinase inhibitor dose management, 23 percent received both AEs of special interest treatment and dose management, and 31 percent received neither.

The most treated AE was hypertension (72 percent of all events), while the least treated was fatigue (9 percent), with only 4 percent of patients receiving pharmacologic treatment for fatigue.

“More emphasis on treatment and prophylaxis options for bothersome adverse events is warranted,” the authors said.

A retrospective chart review was conducted in metastatic renal cell carcinoma patients initiating tyrosine kinase inhibitor monotherapy between 15 November 2010 and 15 November 2013 and experiencing at least one AEs of special interest (eg, diarrhoea, fatigue, hand-foot syndrome, hypertension or stomatitis/mucositis) within 3 months of initiation.

The authors collected demographics, medical history, treatment regimens and AEs of special interest management data for 3.5 months postonset.

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09 Jan 2019
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04 Jan 2019
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