PMID- 24685370
OWN - NLM
STAT- MEDLINE
DCOM- 20150330
LR  - 20220317
IS  - 1557-9816 (Electronic)
IS  - 0955-470X (Linking)
VI  - 28
IP  - 3
DP  - 2014 Jul
TI  - Strategies for the management of adverse events associated with mTOR inhibitors.
PG  - 126-33
LID - S0955-470X(14)00023-8 [pii]
LID - 10.1016/j.trre.2014.03.002 [doi]
AB  - Mammalian target of rapamycin (mTOR) inhibitors are used as potent 
      immunosuppressive agents in solid-organ transplant recipients (everolimus and 
      sirolimus) and as antineoplastic therapies for various cancers (eg, advanced 
      renal cell carcinoma; everolimus, temsirolimus, ridaforolimus). Relevant 
      literature, obtained from specific PubMed searches, was reviewed to evaluate the 
      incidence and mechanistic features of specific adverse events (AEs) associated 
      with mTOR inhibitor treatment, and to present strategies to effectively manage 
      these events. The AEs examined in this review include stomatitis and other 
      cutaneous AEs, wound-healing complications (eg, lymphocele, incisional hernia), 
      diabetes/hyperglycemia, dyslipidemia, proteinuria, nephrotoxicity, delayed graft 
      function, pneumonitis, anemia, hypertension, gonadal dysfunction, and ovarian 
      toxicity. Strategies for selecting appropriate patients for mTOR inhibitor 
      therapy and minimizing the risks of AEs are discussed, along with best practices 
      for identifying and managing side effects. mTOR inhibitors are promising 
      therapeutic options in immunosuppression and oncology; most AEs can be 
      effectively detected and managed or reversed with careful monitoring and 
      appropriate interventions.
CI  - Copyright (c) 2014 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Kaplan, Bruce
AU  - Kaplan B
AD  - Center for Transplantation, University of Kansas Medical Center, Kansas City, KS, 
      USA. Electronic address: bkaplan@kumc.edu.
FAU - Qazi, Yasir
AU  - Qazi Y
AD  - Division of Nephrology, Keck School of Medicine at University of Southern 
      California, Los Angeles, CA, USA.
FAU - Wellen, Jason R
AU  - Wellen JR
AD  - Division of Abdominal Transplant Surgery, Washington University School of 
      Medicine Barnes-Jewish Hospital, Saint Louis, MO, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20140312
PL  - United States
TA  - Transplant Rev (Orlando)
JT  - Transplantation reviews (Orlando, Fla.)
JID - 8804364
RN  - 0 (Antibiotics, Antineoplastic)
RN  - 0 (Immunosuppressive Agents)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Antibiotics, Antineoplastic/*adverse effects
MH  - Graft Rejection/*drug therapy
MH  - Humans
MH  - Immunosuppressive Agents/*adverse effects
MH  - Neoplasms/*drug therapy
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors
EDAT- 2014/04/02 06:00
MHDA- 2015/03/31 06:00
CRDT- 2014/04/02 06:00
PHST- 2013/12/11 00:00 [received]
PHST- 2014/03/04 00:00 [revised]
PHST- 2014/03/08 00:00 [accepted]
PHST- 2014/04/02 06:00 [entrez]
PHST- 2014/04/02 06:00 [pubmed]
PHST- 2015/03/31 06:00 [medline]
AID - S0955-470X(14)00023-8 [pii]
AID - 10.1016/j.trre.2014.03.002 [doi]
PST - ppublish
SO  - Transplant Rev (Orlando). 2014 Jul;28(3):126-33. doi: 10.1016/j.trre.2014.03.002. 
      Epub 2014 Mar 12.