PMID- 27473045
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 1549-490X (Electronic)
IS  - 1083-7159 (Print)
IS  - 1083-7159 (Linking)
VI  - 21
IP  - 11
DP  - 2016 Nov
TI  - Hyperglycemia Associated With Targeted Oncologic Treatment: Mechanisms and 
      Management.
PG  - 1326-1336
LID - 10.1634/theoncologist.2015-0519 [doi]
AB  - : Molecularly targeted cancer therapy has rapidly changed the landscape of 
      oncologic care, often improving patients' prognosis without causing as 
      substantial a quality-of-life decrement as cytotoxic chemotherapy does. 
      Nevertheless, targeted agents can cause side effects that may be less familiar to 
      medical oncologists and that require the attention and expertise of 
      subspecialists. In this review, we focus on hyperglycemia, which can occur with 
      use of new anticancer agents that interact with cell proliferation pathways. Key 
      mediators of these pathways include the tyrosine kinase receptors insulin growth 
      factor receptor 1 (IGF-1R) and epidermal growth factor receptor (EGFR), as well 
      as intracellular signaling molecules phosphatidylinositol 3-kinase (PI3K), AKT, 
      and mammalian target of rapamycin (mTOR). We summarize available information on 
      hyperglycemia associated with agents that inhibit these molecules within the 
      larger context of adverse event profiles. The highest incidence of hyperglycemia 
      is observed with inhibition of IGF-1R or mTOR, and although the incidence is 
      lower with PI3K, AKT, and EGFR inhibitors, hyperglycemia is still a common 
      adverse event. Given the interrelationships between the IGF-1R and cell 
      proliferation pathways, it is important for oncologists to understand the 
      etiology of hyperglycemia caused by anticancer agents that target those pathways. 
      We also discuss monitoring and management approaches for treatment-related 
      hyperglycemia for some of these agents, with a focus on our experience during the 
      clinical development of the EGFR inhibitor rociletinib. IMPLICATIONS FOR 
      PRACTICE: Treatment-related hyperglycemia is associated with several anticancer 
      agents. Many cancer patients may also have preexisting or undiagnosed diabetes or 
      glucose intolerance. Screening can identify patients at risk for hyperglycemia 
      before treatment with these agents. Proper monitoring and management of symptoms, 
      including lifestyle changes and pharmacologic intervention, may allow patients to 
      continue benefiting from use of anticancer agents.
CI  - (c)AlphaMed Press.
FAU - Goldman, Jonathan W
AU  - Goldman JW
AD  - Division of Hematology and Oncology, David Geffen School of Medicine at UCLA, 
      Santa Monica, California, USA jwgoldman@mednet.ucla.edu.
FAU - Mendenhall, Melody A
AU  - Mendenhall MA
AD  - Division of Hematology and Oncology, David Geffen School of Medicine at UCLA, 
      Santa Monica, California, USA.
FAU - Rettinger, Sarah R
AU  - Rettinger SR
AD  - Endocrinology Medical Group of Orange County, Inc., Orange, California, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20160729
PL  - England
TA  - Oncologist
JT  - The oncologist
JID - 9607837
PMC - PMC5189614
OTO - NOTNLM
OT  - Anticancer agents
OT  - Growth factor
OT  - Molecular targeted therapy
OT  - Proto-oncogene protein Akt
OT  - Receptors
OT  - Tyrosine kinase
OT  - mTOR protein
COIS- Disclosures of potential conflicts of interest may be found at the end of this 
      article.
EDAT- 2016/07/31 06:00
MHDA- 2016/07/31 06:01
PMCR- 2017/11/01
CRDT- 2016/07/31 06:00
PHST- 2015/12/17 00:00 [received]
PHST- 2016/06/09 00:00 [accepted]
PHST- 2016/07/31 06:00 [pubmed]
PHST- 2016/07/31 06:01 [medline]
PHST- 2016/07/31 06:00 [entrez]
PHST- 2017/11/01 00:00 [pmc-release]
AID - theoncologist.2015-0519 [pii]
AID - T15519 [pii]
AID - 10.1634/theoncologist.2015-0519 [doi]
PST - ppublish
SO  - Oncologist. 2016 Nov;21(11):1326-1336. doi: 10.1634/theoncologist.2015-0519. Epub 
      2016 Jul 29.