Management of side-effects of targeted therapies m renal cancer: iatrogenic side-effects

摘要

Since premedication of patients with an H1 antihistamine is recommended before the start of the intravenous infusion of temsiroli-mus, temsirolimus is to be used with caution in cases where there is a history of hyper- sensitivity to this class of antihistarnines, or medical contra-indication for treatment with anti-histamines. 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 GYP3A4, anti-hypertensive drugs, antidiabetic drugs, thyroid hormones, and anticoagulant treatments. The combination of bevaeizumab and sunitinib is very toxic (microangiopathic haemolytic anaemia), and is contra-indicated unless part of a clinical trial. Screening, equilibration or treatment of hypothyroi-dism, 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.