Paclitaxel/ramucirumab

Paclitaxel/ramucirumab Reactions 1704, p291 - 2 Jun 2018 Various toxicities: case report A 77-year-old woman developed hypertension, neutropenia, anaemia, urinary protein and loss of appetite while receiving chemotherapy with paclitaxel and ramucirumab [routes not stated]. The woman with gastric cancer had undergone distal gastrectomy and D2 dissection at the age of 76 years. Her histopathological results revealed mucinous carcinoma, HER2 negative, with progression of T4aN3H0P0CY0M0, stage IIIC for which she received adjuvant chemotherapy with gimeracil/ oteracil/tegafur [S-1] for one year. A year and four months after the surgery, recurrence of peritoneal metastases was noted. Therefore, she was started on secondary therapy with paclitaxel and ramucirumab. Before the therapy, her qualitative urinary protein was negative (-), serum creatinine was 0.49 mg/dL with creatinine clearance of 51 mL/min. She started receiving ramucirumab 8 mg/kg on days 1 and 15 along with paclitaxel 80 mg/m , which was administered on days 1, 8 and 15. The adverse events noted the first course were grade III hypertension, grade II neutropenia, anaemia, grade I urinary protein (qualitative 1+, random urinary protein/ Creatinine ratio of 0.75) and loss of appetite. The woman’s treatment with ramucirumab was discontinued due to urinary protein (qualitative 3+, urinary protein/Creatinine ratio of 3.78), but her paclitaxel was continued as monotherapy. Since there was urinary protein on th the 8 day (qualitative 2+, urinary protein/Creatinine ratio of 8.30), ramucirumab was not re-administered. From the third course onward urinary protein (qualitative (-) - (+), urinary protein/cr ratio 0.12 0.39) improved [not all outcomes stated]. Author comment: Ramucirumab (RAM) and paclitaxel (PTX) therapy is recommended as a secondary treatment for advanced recurrent gastric cancer; however, sufficient care is required for characteristic adverse events (AE). The adverse events observed in the first course were gr3 hypertension, gr2 neutropenia, anaemia, gr1 urinary protein (qualitative 1+, random urinary protein/Cr ratio 0.75), and loss of appetite. Kimura Y, et al. A Case of Recurrent Gastric Cancer with Grade 3 Proteinuria Caused by Ramucirumab plus Paclitaxel Therapy. Gan to Kagaku Ryoho 44: 1080-1082, No. 12, Nov 2017 [Japanese; summarised from a translation] - Japan 803322735 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Paclitaxel/ramucirumab

Reactions Weekly , Volume 1704 (1) – Jun 2, 2018
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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
D.O.I.
10.1007/s40278-018-46934-3
Publisher site
See Article on Publisher Site

Abstract

Reactions 1704, p291 - 2 Jun 2018 Various toxicities: case report A 77-year-old woman developed hypertension, neutropenia, anaemia, urinary protein and loss of appetite while receiving chemotherapy with paclitaxel and ramucirumab [routes not stated]. The woman with gastric cancer had undergone distal gastrectomy and D2 dissection at the age of 76 years. Her histopathological results revealed mucinous carcinoma, HER2 negative, with progression of T4aN3H0P0CY0M0, stage IIIC for which she received adjuvant chemotherapy with gimeracil/ oteracil/tegafur [S-1] for one year. A year and four months after the surgery, recurrence of peritoneal metastases was noted. Therefore, she was started on secondary therapy with paclitaxel and ramucirumab. Before the therapy, her qualitative urinary protein was negative (-), serum creatinine was 0.49 mg/dL with creatinine clearance of 51 mL/min. She started receiving ramucirumab 8 mg/kg on days 1 and 15 along with paclitaxel 80 mg/m , which was administered on days 1, 8 and 15. The adverse events noted the first course were grade III hypertension, grade II neutropenia, anaemia, grade I urinary protein (qualitative 1+, random urinary protein/ Creatinine ratio of 0.75) and loss of appetite. The woman’s treatment with ramucirumab was discontinued due to urinary protein (qualitative 3+, urinary protein/Creatinine ratio of 3.78), but her paclitaxel was continued as monotherapy. Since there was urinary protein on th the 8 day (qualitative 2+, urinary protein/Creatinine ratio of 8.30), ramucirumab was not re-administered. From the third course onward urinary protein (qualitative (-) - (+), urinary protein/cr ratio 0.12 0.39) improved [not all outcomes stated]. Author comment: Ramucirumab (RAM) and paclitaxel (PTX) therapy is recommended as a secondary treatment for advanced recurrent gastric cancer; however, sufficient care is required for characteristic adverse events (AE). The adverse events observed in the first course were gr3 hypertension, gr2 neutropenia, anaemia, gr1 urinary protein (qualitative 1+, random urinary protein/Cr ratio 0.75), and loss of appetite. Kimura Y, et al. A Case of Recurrent Gastric Cancer with Grade 3 Proteinuria Caused by Ramucirumab plus Paclitaxel Therapy. Gan to Kagaku Ryoho 44: 1080-1082, No. 12, Nov 2017 [Japanese; summarised from a translation] - Japan 803322735 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704

Journal

Reactions WeeklySpringer Journals

Published: Jun 2, 2018

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