title: Serum creatine kinase increase in patients treated with tyrosine kinase inhibitors for solid tumors.
abstract: Regarding the frequency of muscular complains with the use of tyrosine kinase inhibitors (TKIs), we hypothesize that creatine kinase (CK) elevation may be more frequent than usually reported. We conducted a prospective study on patients treated with TKIs for solid tumors, to assess the incidence of CK increase on treatment. Most of the patients (105/155) had a gastrointestinal stromal tumor. Treatments were carried out with the following drugs: imatinib (87 cases); sunitinib (21 cases); HER antagonists (14 cases), other TKIs (15 cases); and imatinib-based combinations (2 cases). Myalgias were found in 50/155 patients (32%). Fifty-four patients (35%; 95%CI, 27-42%) had elevated CK. According to NCI-CTC grading, there was 49/54 (31%) grade 1 and 5/54 (3%) grade 2 (2.5 to 5 times ULN). CK elevation was more frequent with imatinib than with other TKIs (39 cases, 45% vs. 14 cases, 21%, respectively; chi-squared test: P=0.003), and CK was more likely to be abnormal in patients treated with any TKI for more than 6 months. We found increased CK in about one-third of patients under TKIs for solid tumors, including 3% of patients with CK as high as 2.5-5 times ULN.
authors.affiliation: Medical Oncology Department, Centre Oscar Lambret, BP307, 59020, Lille, France. a-adenis@o-lambret.fr
authors.forename: Antoine
authors.initials: A
authors.lastname: Adenis
authors.forename: Olivier
authors.initials: O
authors.lastname: Bouché
authors.forename: François
authors.initials: F
authors.lastname: Bertucci
authors.forename: Elsa
authors.initials: E
authors.lastname: Kalbacher
authors.forename: Charles
authors.initials: C
authors.lastname: Fournier
authors.forename: Philippe
authors.initials: P
authors.lastname: Cassier
authors.forename: Olivier
authors.initials: O
authors.lastname: Collard
authors.forename: Jacques-Olivier
authors.initials: JO
authors.lastname: Bay
authors.forename: Antoine
authors.initials: A
authors.lastname: Italiano
authors.forename: Christine
authors.initials: C
authors.lastname: Chevreau
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Clisant
authors.forename: Andrew
authors.initials: A
authors.lastname: Kramar
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Blay
authors.forename: Nicolas
authors.initials: N
authors.lastname: Penel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001549:Benzamides / Q000009:adverse effects; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D010879:Piperazines / Q000009:adverse effects; D011446:Prospective Studies; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011743:Pyrimidines / Q000009:adverse effects
chemical_list: D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases; D003402:Creatine Kinase