Cetin Bulent, Coskun Ugur, Yildiz Ramazan, Buyukberber Suleyman, Baykara Meltem, Benekli Mustafa
Department of Medical Oncology, School of Medicine, Gazi University, Ankara, Turkey.
J Oncol Pharm Pract. 2011 Sep;17(3):274-8. doi: 10.1177/1078155210363317. Epub 2010 Mar 9.
Everolimus (RAD001) is an orally administered inhibitor of the mammalian target of rapamycin (mTOR), a therapeutic target for metastatic renal cell carcinoma. A 58-year-old woman was treated with everolimus as a third-line therapy for metastatic clear-cell renal carcinoma. She was given oral everolimus 10 mg once daily. During the fourth week of her first cycle, the patient was admitted to our hospital because of an acute-onset, right upper quadrant pain associated with nausea and vomiting. She was diagnosed with acute cholecystitis, which was treated with broad-spectrum antibiotics, and everolimus therapy was discontinued. A follow-up computed tomography scan of the abdomen revealed a complete resolution of gallbladder changes. Our patient did not have major risk factors for developing a cholecystitis except for a relative immunosuppressed state secondary to her advanced renal cancer. The Naranjo adverse drug reaction probability scale score for this event was 5, indicating a probable association of the event with everolimus. Because the use of everolimus is expanding in clinical practice, we want to alert the oncology community about this uncommon and life-threatening complication in patients receiving everolimus or another agent with antiangiogenic activity. To our best knowledge, only one case of an acute cholangitis associated with everolimus in a metastatic renal cell carcinoma has been reported. We report herein the first case of a metastatic renal cell carcinoma developed everolimus-associated cholecystitis that was completely reversed after drug withdrawal.
依维莫司（RAD001）是一种口服的哺乳动物雷帕霉素靶蛋白（mTOR）抑制剂，mTOR是转移性肾细胞癌的一个治疗靶点。一名58岁女性接受依维莫司治疗，作为转移性透明细胞肾细胞癌的三线治疗方案。她每天口服依维莫司10毫克。在第一个周期的第四周，患者因突发右上腹疼痛伴恶心、呕吐入住我院。她被诊断为急性胆囊炎，接受了广谱抗生素治疗，依维莫司治疗中断。腹部后续计算机断层扫描显示胆囊病变完全消退。除了因晚期肾癌导致的相对免疫抑制状态外，我们的患者没有发生胆囊炎的主要危险因素。该事件的纳伦霍药物不良反应概率量表评分为5分，表明该事件可能与依维莫司有关。由于依维莫司在临床实践中的应用正在扩大，我们希望提醒肿瘤学界注意这种在接受依维莫司或其他具有抗血管生成活性药物的患者中出现的罕见且危及生命的并发症。据我们所知，仅有1例转移性肾细胞癌患者发生与依维莫司相关的急性胆管炎的报道。我们在此报告首例转移性肾细胞癌发生依维莫司相关胆囊炎且停药后完全逆转的病例。
