Radiomètre hyperfréquence La détection de l’émission propre constitue a de ce rayonnement dans le plasma dépend de la distribution de l’indice de réfraction. donné lieu à peu de recherches, ou du moins à peu de publications (Letarte. J Letarte’s 83 research works with citations and reads, including: Resultats du traitement a long terme d’un garcon de 7 ans dont l’activite ornithine .. to evaluate the cardiac dimensions and various indices of myocardial function . Suivre. Dominic Letarte Adresse e-mail validée de – Page d’accueil E Merlo, D Letarte, G Antoniol F Gauthier, D Letarte, T Lavoie, E Merlo.

Author: Grobar Akilrajas
Country: Venezuela
Language: English (Spanish)
Genre: Medical
Published (Last): 12 August 2010
Pages: 56
PDF File Size: 7.41 Mb
ePub File Size: 8.1 Mb
ISBN: 570-6-51697-613-7
Downloads: 30801
Price: Free* [*Free Regsitration Required]
Uploader: Julmaran

This rare toxicity has been seen with other small-molecule tyrosine kinase inhibitors, including gefitinib and erlotinib. Toxicity ctcae grade Toxicity description Dosing Hematologic toxicity Grade 3 anc: The visual effects are predominantly grade 1, and in the profile and trials, no patients required dose interruptions or reductions because of them 8 Most patients reported that the visual effects were not at all or only a little bothersome.

Cardiac Effects Crizotinib is associated with two main cardiac effects: Heart rate decrease is a pharmacodynamic effect of crizotinib, averaging 2. Dose modifications ketarte crizotinib related adverse events Crizotinib versus chemotherapy in advanced ALK-positive lung cancer.

Support Center Support Center. Prochlorperazine and 5-HT 3 receptor antagonists such as ondansetron should be avoided or used with caution because of the risk of QT prolongation. Food letarfe Drug Administration and Health Canada.

Managing treatment–related adverse events associated with Alk inhibitors

Patients on treatment for more than 6 months did not have any new ae s or issues related to prolonged exposure 8. The events were short-lived, typically lasting less than 1 minute. Rare Complications of Crizotinib Complex renal cysts were seen very infrequently in patients treated with crizotinib. Table IV Incidence of hepatic laboratory abnormalities among patients in profile and profile Grade 2, 3, or 4 alt or ast elevation and concurrent grade 2, 3, or 4 total bilirubin elevation c.


A number of reports describe patients who continued to respond systemically, but who progressed in the cns 17 Testosterone levels and quality of life in diverse male patients with cancers unrelated to androgens.

Clinical impact of continued crizotinib administration after isolated central nervous system progression in patients with lung cancer positive for ALK rearrangement. Successful crizotinib re-treatment has been described with the addition of steroid premedication, but further data are required to evaluate the safety of that maneuver Hypogonadism occurs quite commonly in patients with advanced cancer, and it is often underdiagnosed and rarely treated Temporary discontinuation or dose reduction because of a hepatic adverse event occurred in 5.

Given that these agents often target multiple pathways, it is important to recognize both on-target and off-target effects so as to anticipate and treat toxicities that arise.

Managing treatment–related adverse events associated with Alk inhibitors

The field of oncology has entered an era of molecularly targeted therapy. There was no associated renal impairment, and the significance of these occurrences is unknown Because of the high incidence of baseline pulmonary disease, radiation-related changes, infectious complications, and presence of progressive malignancy, a diagnosis of drug-induced pneumonitis can be difficult to make in lung cancer patients. A pooled analysis of profile and that included more than patients treated with crizotinib calculated the overall incidence of liver enzyme abnormalities Table iv In non-small-cell lung cancer nsclcthe shift was first seen with the discovery that mutations in the epidermal growth factor receptor predicted responsiveness to epidermal growth factor receptor tyrosine kinase inhibitors.

Once infectious causes for diarrhea have been excluded, standard nonpharmacologic measures dietary adjustment and hydration and antidiarrheal medications such as loperamide can be used. Grades 1 and 2 kndice and, to a lesser extent, constipation lettarte both be seen with crizotinib Table i. Nausea, vomiting, and diarrhea tend to occur early in treatment median time to onset: If the undice is low, endocrinology referral should be arranged to discuss the pros and cons of testosterone replacement therapy Successful crizotinib retreatment after crizotinib-induced interstitial lung disease.


The most common side effect of crizotinib is visual disturbance. A phase i trial in advanced ALK -positive nsclc profile demonstrated an impressive Moderate inhibitors of CYP3A4 should be used with caution, and crizotinib toxicity should be monitored.

In clinical practice, patients on crizotinib do not require baseline or routine ophthalmologic assessments. In the profile trial, a heart rate decrease by a mean of An exploratory analysis looked at the correlation between heart rate decrease and clinical response, and further study is required. Visual effects in anaplastic lymphoma kinase ALK -positive advanced non-small cell lung cancer nsclc patients treated with crizotinib [abstract ] J Clin Oncol.

However, if visual changes worsen in severity, ophthalmologic evaluation should be considered. Typically, this disturbance occurs early median time to onset of less than 2 weeks. Grade 2, 3, or 4 alt or ast elevation and concurrent grade 2, 3, or 4 total bilirubin elevation c Bilirubin Grade 2: Drug Interactions Crizotinib is metabolized predominantly by CYP3A, and so co-administration with strong inhibitors of CYP3A4 such as ketoconazole increases the area under the curve of crizotinib and should be avoided.

Although those inhibitors are generally well tolerated, they have a unique side effect profile that differs from that of traditional cytotoxic therapy. Results of a global phase ii study with crizotinib in advanced ALK-positive non-small cell lung cancer nsclc [abstract ] J Clin Oncol.

Although the possibility of serious ae s from crizotinib is relatively low, proactive monitoring is important to mitigate the risk.