Life-threatening complications associated with the tyrosine kinase inhibitor sunitinib malate.
Adverse events associated with sunitinib, such as cardiac toxicities, renal damage, and hemostatic complications, are well known. The authors report 3 cases in which patients experienced severe life-threatening complications after commencing sunitinib treatment. One patient developed heart failure with dilation of the left ventricle and decrease in the ejection fraction after one cycle of sunitinib and required treatment with an angiotensin-converting enzyme inhibitor, loop diuretics, and dobutamine. Another patient developed coronary artery stenosis after one cycle of sunitinib and was managed through percutaneous coronary intervention. Although follow-on coronary angiography revealed normal findings after 6 further cycles of sunitinib, this patient eventually expired due to multi-organ failure. The third patient had chronic renal failure before sunitinib treatment and required hemodialysis due to acute-on-chronic renal failure after commencing sunitinib treatment.
Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea.
Tae Joon
TJ
Lim
Jee Han
JH
Lee
Sung-Goo
SG
Chang
Choong Hyun
CH
Lee
Gyeong Eun
GE
Min
Koo Han
KH
Yoo
Seung Hyun
SH
Jeon
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D023921:Coronary Stenosis / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006333:Heart Failure / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000139:chemically induced; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D011758:Pyrroles / Q000009:adverse effects*; D006435:Renal Dialysis; D000077210:Sunitinib; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D002317:Cardiovascular Agents; D007211:Indoles; D047428:Protein Kinase Inhibitors; D011758:Pyrroles; D000077210:Sunitinib