title: [Management of side effects of targeted therapies in renal cancer: iatrogenic side effects].
abstract: Since premedication of patients with an H1 antihistamine is recommended before the start of the intravenous infusion of temsirolimus, temsirolimus is to be used with caution in cases where there is a history of hypersensitivity to this class of antihistamines, or medical contra-indication for treatment with antihistamines. Comorbidities and co-medications must be taken into account in the prescription of targeted therapies. For sunitinib, sorafenib, and pazopanib: potential drug interactions are possible with inducers/inhibitors of CYP3A4, anti-hypertensive drugs, antidiabetic drugs, thyroid hormones, and anticoagulant treatments. The combination of bevacizumab and sunitinib is very toxic (microangiopathic haemolytic anaemia), and is contra-indicated unless part of a clinical trial. Screening, equilibration or treatment of hypothyroidism, anaemia, undernutrition, hypophosphatemia, hypomagnesaemia, sleep disorders, depression or other comorbidities, which may contribute to asthenia is recommended. In patients treated with sunitinib or pazopanib, a thyroid function test is recommended at the treatment centre as well as regular TSH assays.
authors.affiliation: Institut Gustave-Roussy, médecine immunothérapie, 39, rue Camille-Desmoulins, 94805 Villejuif Cedex, France. Electronic address: christophe.massard@igr.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Massard
authors.affiliation: CHU Pontchaillou, urologie, 2, rue Henri-le-Guilloux, 35033 Rennes Cedex 9, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Patard
authors.affiliation: CHU Necker-Enfants-Malades, hématologie, 161, rue de Sèvres 75743 Paris Cedex 15, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Hermine
authors.affiliation: Centre hospitalier Saint-André, oncologie médicale, 1, rue Jean-Burguet, 33075 Bordeaux Cedex, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Ravaud
keywords: CYP3A4; antivitaminK; antivitamineK; asthenia; asthénie; drug interactions; hypothyroidism; hypothyroïdie; interactions médicamenteuses