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Serosal inflammation (pleural and pericardial effusions) related to tyrosine kinase inhibitors

Kevin Kelly1, Ronan Swords, Devalingam Mahalingam

  • 1Institute for Drug Development, Cancer Therapy and Research Center, The University of Texas Health Science Center, San Antonio, TX, USA. KellyKR@uthscsa.edu

Targeted Oncology
|April 22, 2009
PubMed

Insights

Tyrosine kinase inhibitors (TKIs) can cause serosal inflammation, like pleural effusions, particularly with dasatinib. Understanding this adverse event is crucial for managing cancer patients on TKI therapy.

Area of Science:

  • Oncology
  • Pharmacology
  • Hematology

Background:

  • Tyrosine kinase inhibitors (TKIs) have revolutionized cancer treatment, especially chronic myeloid leukemia (CML).
  • Off-target kinase inhibition by TKIs can lead to significant adverse events.
  • Serosal inflammation, manifesting as pleural and pericardial effusions, is a notable side effect associated with certain TKIs.

Purpose of the Study:

  • To highlight the clinical significance of serosal inflammation as an adverse event in patients treated with TKIs.
  • To compare the frequency of serosal inflammation with dasatinib versus imatinib and nilotinib.
  • To discuss the challenges in predicting, timing, and managing TKI-induced serosal inflammation.

Main Methods:

  • Review of clinical data and literature concerning TKI-induced adverse events.
  • Comparative analysis of the incidence of serosal inflammation among different TKIs.
  • Discussion of potential pathogenetic mechanisms.

Main Results:

  • Serosal inflammation, including pleural and pericardial effusions, is a frequent adverse event with dasatinib.
  • This adverse event occurs significantly less frequently with imatinib and nilotinib.
  • The exact pathogenesis remains uncertain, with potential roles for platelet-derived growth factor inhibition or immune cell modulation.

Conclusions:

  • Dasatinib is associated with a higher incidence of serosal inflammation compared to imatinib and nilotinib.
  • The unpredictable onset and variable management of TKI-induced serosal inflammation present clinical challenges.
  • Further research into the pathogenesis is needed to guide management strategies for this adverse event.

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