PMID- 22437824
OWN - NLM
STAT- MEDLINE
DCOM- 20121213
LR  - 20220309
IS  - 1097-0142 (Electronic)
IS  - 0008-543X (Linking)
VI  - 118
IP  - 20
DP  - 2012 Oct 15
TI  - Clinical and histopathologic characteristics of rash in cancer patients treated 
      with mammalian target of rapamycin inhibitors.
PG  - 5078-83
LID - 10.1002/cncr.27505 [doi]
AB  - BACKGROUND: Dermatologic adverse events stemming from anticancer therapies have 
      become an increasingly frequent clinical problem. Inhibitors of mammalian target 
      of rapamycin (mTOR), such as temsirolimus and everolimus, have been associated 
      with a high rate of skin eruptions, but their clinical and histopathologic 
      characteristics have not been explored. METHODS: A retrospective analysis of 
      patients who were referred to the Dermatology Service for diagnosis and 
      management of rash in the setting of therapy with the mTOR inhibitors everolimus 
      and temsirolimus was performed. The parameters that were studied included the 
      time to onset, clinical presentation at the time of dermatologic evaluation, 
      associated symptoms, evolution, results of microbiologic studies, concomitant 
      medications, the need for dose reduction and/or treatment interruption because of 
      rash, and routine histopathology. RESULTS: In total, 13 patients were analyzed. 
      Most rashes were mild (grade 1; 31%) and moderate (grade 2; 54%) in severity, and 
      grade 3 rashes were observed only in 2 patients (15%). The trunk was the most 
      frequently affected region (77%), with the scalp (23%), face (38%), neck (54%), 
      and extremities (69%) also commonly involved. Erythematous papules and pustules 
      constituted the predominant primary lesion morphology (62%). No unique or uniform 
      histopathologic reaction pattern was observed. The most common reaction pattern 
      was that of a mixed, spongiotic interface and perivascular dermatitis, which was 
      observed in 7 of 11 patients (63%). CONCLUSIONS: Although mTOR inhibitors may 
      commonly induce erythematous papules and pustules, they are associated with a 
      spectrum of lesion morphologies and a variety of histopathologic findings. 
      Further clinicohistologic correlation studies are needed.
CI  - Copyright (c) 2012 American Cancer Society.
FAU - Balagula, Yevgeniy
AU  - Balagula Y
AD  - Department of Medicine, Dermatology Service, Memorial Sloan-Kettering Cancer 
      Center, New York, NY 10022, USA.
FAU - Rosen, Alyx
AU  - Rosen A
FAU - Tan, Belinda H
AU  - Tan BH
FAU - Busam, Klaus J
AU  - Busam KJ
FAU - Pulitzer, Melissa P
AU  - Pulitzer MP
FAU - Motzer, Robert J
AU  - Motzer RJ
FAU - Feldman, Darren R
AU  - Feldman DR
FAU - Konner, Jason A
AU  - Konner JA
FAU - Reidy-Lagunes, Diane
AU  - Reidy-Lagunes D
FAU - Myskowski, Patricia L
AU  - Myskowski PL
FAU - Lacouture, Mario E
AU  - Lacouture ME
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120321
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
RN  - 0 (Antineoplastic Agents)
RN  - 624KN6GM2T (temsirolimus)
RN  - 9HW64Q8G6G (Everolimus)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Agents/*adverse effects
MH  - Everolimus
MH  - Exanthema/*chemically induced/pathology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Sirolimus/adverse effects/*analogs & derivatives
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors
EDAT- 2012/03/23 06:00
MHDA- 2012/12/14 06:00
CRDT- 2012/03/23 06:00
PHST- 2011/09/29 00:00 [received]
PHST- 2012/01/27 00:00 [revised]
PHST- 2012/01/31 00:00 [accepted]
PHST- 2012/03/23 06:00 [entrez]
PHST- 2012/03/23 06:00 [pubmed]
PHST- 2012/12/14 06:00 [medline]
AID - 10.1002/cncr.27505 [doi]
PST - ppublish
SO  - Cancer. 2012 Oct 15;118(20):5078-83. doi: 10.1002/cncr.27505. Epub 2012 Mar 21.