Occurrence of abscesses during treatment with pazopanib in metastatic renal cancer: a case report

Ivana Puliafito,Dorotea Sciacca,Caterina Puglisi,Alessio Russo,Dario Giuffrida

doi:10.1186/s13256-019-2318-y

Abstract

BackgroundPazopanib is a multitarget tyrosine kinase inhibitor used in the treatment of renal cancer and soft tissue sarcoma. Its use is commonly associated with a number of side effects, such as hemorrhagic diathesis, neutropenia, leukopenia, thrombocytopenia, nausea, vomiting, abdominal pain, increased serum aspartate aminotransferase, increased serum alanine aminotransferase, decreased serum glucose, increased serum bilirubin, decreased serum phosphate and magnesium, fatigue, hypertension, diarrhea, anorexia, proteinuria, and hypothyroidism. Abscesses of metastases caused by pazopanib administration are rarely reported in the literature.Case presentationWe report a case of abscesses of lung metastases related to pazopanib in a patient with metastatic renal cancer. The patient was a 53-year-old Caucasian man who developed abscesses of lung metastases during the first 3 months of treatment with pazopanib. The abscesses resolved after 1 month by stopping pazopanib and administering adequate antibiotic therapy.ConclusionsWe conclude that abscesses of metastases could be a rare side effect occurring during treatment with pazopanib in patients with renal cancer.

Highlights

Pazopanib (Votrient; Novartis, East Hanover, NJ, USA) is a tyrosine kinase inhibitor used to treat kidney cancer and soft tissue sarcoma (STS)
We conclude that abscesses of metastases could be a rare side effect occurring during treatment with pazopanib in patients with renal cancer
The study highlighted that most of the treatment-emergent adverse events were grade 1 or 2, even though grade 3/4 hypertension and diarrhea were observed with appreciable incidence and four pazopanib-treated patients had fatal adverse effects

Summary

Introduction

Pazopanib (Votrient; Novartis, East Hanover, NJ, USA) is a tyrosine kinase inhibitor used to treat kidney cancer and soft tissue sarcoma (STS). This drug is a multikinase inhibitor that has been demonstrated to inhibit vascular endothelial growth factor receptors (VEGFR-1, -2, and -3), platelet-derived growth factor receptor-α and -β, fibroblast growth factor receptor-1 and -3, and c-KIT. After 3 months, he had a repeat CT scan (Fig. 1b), which revealed evidence of necrotizing metastases with cavitation on the lung similar to abscesses in the absence of fever He stopped pazopanib and started therapy with antibiotics as suggested by a pneumologist. One month after starting antibiotics, a CT scan showed resolution of the patient’s abscesses but progressive disease (Fig. 1c)

Discussion

Conclusions