PMID- 35738914
OWN - NLM
STAT- MEDLINE
DCOM- 20220718
LR  - 20220718
IS  - 1769-6917 (Electronic)
IS  - 0007-4551 (Linking)
VI  - 109
IP  - 7-8
DP  - 2022 Jul-Aug
TI  - [Metastatic renal cell carcinoma: Management of toxicities of combinations].
PG  - 844-861
LID - S0007-4551(22)00197-7 [pii]
LID - 10.1016/j.bulcan.2022.04.019 [doi]
AB  - New combinations of antiangiogenic tyrosine kinase inhibitors (TKI) and immune 
      checkpoint inhibitors (ICI) or dual ICI have been shown to be effective in phase 
      III trials compared to sunitinib in the first-line treatment of metastatic renal 
      cell cancer. While ICI doublet is already used in other indications, TKI/ICI 
      combinations are more recent and the management of their adverse effects (AEs) 
      are less well known, particularly with regard to the accountability of each 
      therapeutic class. The objective of this article is to analyze the safety data 
      from the main phase III studies to provide clinicians with practical advice for 
      managing the AEs from these combinations. Their management depends largely on the 
      type of combination and their grade. In the case of a TKI/ICI combination, 
      discontinuation of the 2 molecules is considered from grade 2. Rapid improvement 
      in symptoms suggests that the AE is related to the TKI. It is then possible, 
      after resolution, to reintroduce the TKI, if needed by reducing the dose, and to 
      continue the ICI. Otherwise, the blame falls on the ICI and treatment usually 
      involves corticosteroids. Management also depends on the type of AE and its 
      severity. In some cases (dysthyroidism), treatment with TKI/ICI may be continued. 
      In other situations (cardiac or neurological toxicity), it should be discontinued 
      from grade 1 and hospitalization and corticosteroid therapy should be considered 
      immediately. In all cases, information and education are integral parts of the 
      prevention and proper management of potential AEs.
CI  - Copyright (c) 2022. Published by Elsevier Masson SAS.
FAU - Joly, Florence
AU  - Joly F
AD  - Universite Unicaen, centre Francois-Baclesse, service d'oncologie medicale, Caen, 
      France. Electronic address: f.joly@baclesse.unicancer.fr.
FAU - Michot, Jean-Marie
AU  - Michot JM
AD  - Gustave-Roussy Cancer Center, Cancer Campus Grand Paris, departement des 
      innovations therapeutiques et essais precoces (DITEP), ImmunoTOX committee of 
      Gustave-Roussy, Villejuif, France.
FAU - Dourthe, Louis Marie
AU  - Dourthe LM
AD  - Clinique Saint-Anne, service d'oncologie medicale, Strasbourg, France.
FAU - Flechon, Aude
AU  - Flechon A
AD  - Centre Leon-Berard, departement d'oncologie medicale, Lyon, France.
FAU - Mahammedi, Hakim
AU  - Mahammedi H
AD  - Centre Jean-Perrin, departement d'oncologie medicale, Clermont-Ferrand, France.
FAU - Maillet, Denis
AU  - Maillet D
AD  - Hospices civils de Lyon, centre de recherche en cancerologie de Lyon, centre 
      hospitalier Lyon Sud, institut de cancerologie, departement d'oncologie medicale, 
      ImmuCare (Immunology Cancer Research), Lyon, France.
FAU - Mouillet, Guillaume
AU  - Mouillet G
AD  - CHU de Minjoz, departement d'oncologie medicale, Besancon, France.
FAU - Pouessel, Damien
AU  - Pouessel D
AD  - Institut Claudius-Regaud, departement d'oncologie medicale, IUCT Oncopole, 
      Toulouse, France.
FAU - Rolland, Frederic
AU  - Rolland F
AD  - Institut de cancerologie de l'Ouest, departement d'oncologie medicale, 
      Saint-Herblain, France.
FAU - Topart, Delphine
AU  - Topart D
AD  - Hopital Saint-Eloi, CHU de Montpellier, departement d'oncologie medicale, 
      Montpellier, France.
FAU - Albiges, Laurence
AU  - Albiges L
AD  - Universite Paris Saclay, institut Gustave-Roussy, Villejuif, France.
LA  - fre
PT  - Journal Article
PT  - Review
TT  - Cancer du rein metastatique : gestion des toxicites des combinaisons.
DEP - 20220621
PL  - France
TA  - Bull Cancer
JT  - Bulletin du cancer
JID - 0072416
RN  - V99T50803M (Sunitinib)
SB  - IM
MH  - *Carcinoma, Renal Cell/secondary
MH  - Humans
MH  - *Kidney Neoplasms/pathology
MH  - Sunitinib/adverse effects
OTO - NOTNLM
OT  - Cancer du rein metastatique
OT  - Combinaisons
OT  - Combinations
OT  - First-line treatment
OT  - Immunotherapy
OT  - Immunotherapie
OT  - Metastatic renal cancer
OT  - Toxicities
OT  - Toxicites
OT  - Traitement en premiere ligne
EDAT- 2022/06/24 06:00
MHDA- 2022/07/19 06:00
CRDT- 2022/06/23 22:02
PHST- 2022/01/20 00:00 [received]
PHST- 2022/04/15 00:00 [revised]
PHST- 2022/04/23 00:00 [accepted]
PHST- 2022/06/24 06:00 [pubmed]
PHST- 2022/07/19 06:00 [medline]
PHST- 2022/06/23 22:02 [entrez]
AID - S0007-4551(22)00197-7 [pii]
AID - 10.1016/j.bulcan.2022.04.019 [doi]
PST - ppublish
SO  - Bull Cancer. 2022 Jul-Aug;109(7-8):844-861. doi: 10.1016/j.bulcan.2022.04.019. 
      Epub 2022 Jun 21.