title: [Side effect management of tyrosine kinase inhibitors in urology : Gastrointestinal side effects].
abstract: For approximately one decade, tyrosinkinase inhibitors (TKIs, smart drugs) have dramatically changed and improved the treatment of patients suffering from metastasized renal cell carcinoma. However, the different drugs have substantial side effects. Especially gastrointestinal symptoms may be problematic for patients. These side effects represent a challenge for the physician. On the one hand, dosage modifications and treatment interruption should be avoided to minimize the risk for progression. On the other hand, only mild side effects are tolerable for the patient. Based on a literature review, a clear overview of the incidence of possible side effects for the drugs axitinib, cabozantinib, pazopanib, sorafenib, and sunitinib is provided. Furthermore, we give a practical guide on how to prevent and treat the different gastrointestinal side effects. Finally, it is pointed out when dosage modifications or interruption of treatment are necessary and how to expeditiously re-escalate the treatment after mitigation of side effects.
authors.affiliation: Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Rathsberger Str. 57, 91054, Erlangen, Deutschland.
authors.forename: V
authors.initials: V
authors.lastname: Lieb
authors.affiliation: Klinik und Poliklinik für Urologie, Universitätsklinikum Hamburg Eppendorf, Hamburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Rink
authors.affiliation: Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Rathsberger Str. 57, 91054, Erlangen, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Sikic
authors.affiliation: Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Rathsberger Str. 57, 91054, Erlangen, Deutschland. bastian.keck@uk-erlangen.de.
authors.forename: B
authors.initials: B
authors.lastname: Keck
mesh_terms: D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods*; D019317:Evidence-Based Medicine; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000150:complications / Q000188:drug therapy
chemical_list: D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases
keywords: Axitinib; Cabozantinib; Pazopanib; Sorafenib; Sunitinib