title: Everolimus: side effect profile and management of toxicities in breast cancer.
abstract: Everolimus is an orally available inhibitor of the mammalian target of rapamycin (mTOR), which has been approved in combination with exemestane for hormone receptor-positive (HR) breast cancer after failure of treatment with non-steroidal aromatase inhibitors. Everolimus is generally very well tolerated with most common side effects including stomatitis, rash, fatigue, hyperglycemia, hyperlipidemia, and myelosuppression. Most of these side effects are mild and resolve with dose interruptions or dose reductions. Symptomatic non-infectious pneumonitis is a relatively uncommon class effect of mTOR inhibitors, which can be life threatening. Given the efficacy of everolimus in HR-positive metastatic breast cancer, it is crucial for physicians to recognize toxicities related to everolimus and start timely interventions. This review will focus on the adverse events reported with everolimus in breast cancer trials and will provide practical guidelines for the management of these adverse events.
authors.affiliation: Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, 1365 Clifton Road, Atlanta, GA 30322, USA.
authors.forename: Elisavet
authors.initials: E
authors.lastname: Paplomata
authors.forename: Amelia
authors.initials: A
authors.lastname: Zelnak
authors.forename: Ruth
authors.initials: R
authors.lastname: O'Regan
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D000068338:Everolimus; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced; D006949:Hyperlipidemias / Q000139:chemically induced; D011014:Pneumonia / Q000139:chemically induced; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology; D013280:Stomatitis / Q000139:chemically induced; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors
chemical_list: D000970:Antineoplastic Agents; D000068338:Everolimus; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; D020123:Sirolimus