Mechanisms of TKI-induced diarrhea in cancer patients

Joanne M Bowen1

  • 1School of Medical Sciences, University of Adelaide, South Australia, Australia. joanne.bowen@adelaide.edu.au

Abstract

Insights

Tyrosine kinase inhibitor (TKI) diarrhea is a common side effect hindering cancer treatment. Research into TKI-induced gut injury mechanisms, particularly using rodent models, is crucial for better patient management.

Area of Science:

  • Oncology
  • Gastroenterology
  • Pharmacology

Background:

  • Tyrosine kinase inhibitors (TKIs) are widely used cancer therapeutics.
  • TKI-induced diarrhea is a frequent and significant side effect.
  • The mechanisms underlying TKI-induced diarrhea are poorly understood.

Purpose of the Study:

  • To review the current understanding of TKI-induced diarrhea.
  • To explore research models for studying TKI-induced gut injury.
  • To discuss future directions for managing this side effect.

Main Methods:

  • Review of existing literature on TKI-induced diarrhea.
  • Discussion of rodent models employed in TKI-induced gut injury research.
  • Analysis of pharmacological targets of TKIs in relation to gastrointestinal effects.

Main Results:

  • Limited knowledge exists regarding the human mechanisms of TKI-induced diarrhea.
  • Rodent models provide insights into TKI-induced gastrointestinal injury.
  • Understanding TKI targets may inform tailored patient management strategies.

Conclusions:

  • Recognizing TKI-induced diarrhea as a significant complication is driving research.
  • Elucidating the pathogenesis of TKI-induced diarrhea is essential.
  • Improved understanding will lead to better management of patients receiving TKIs.

Related Concept Videos

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates these...
Drugs Affecting GI Tract Motility: Adsorbents as Antidiarrheal Agents01:20

Drugs Affecting GI Tract Motility: Adsorbents as Antidiarrheal Agents

Diarrhea is characterized by the occurrence of frequent, watery bowel movements. Various factors can trigger diarrhea, including viral or bacterial infections, foodborne illnesses, side effects from certain medications, and underlying digestive disorders. If not adequately managed, diarrhea can lead to complications such as dehydration, electrolyte imbalances, and nutrient deficiencies. Severe diarrhea can lead to significant weight loss, malnutrition, and weakened immune function.
Adsorbents...
Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents01:18

Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents

Acute diarrhea, a common gastrointestinal disturbance, is characterized by the rapid evacuation of fluid stools, leading to an excessive weight in fluid. This condition typically arises from disorders affecting intestinal water and electrolyte transport. It can be triggered by an increased osmotic load within the intestine, excessive secretion of electrolytes and water, mucosal exudation of protein and fluid, or altered intestinal motility. The primary risks of acute diarrhea are dehydration...
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents01:17

Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents

Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists

5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
Cytotoxic T Cells-mediated Immune Response01:27

Cytotoxic T Cells-mediated Immune Response

Cytotoxic T cells are a vital component of the immune system. They have the remarkable ability to identify and target antigens on infected or abnormal cells. These antigens often originate from intracellular pathogens such as viruses or abnormal proteins cancer cells produce.
Immunological surveillance is the ability of immune cells to monitor and eliminate infected cells with intracellular pathogens, neoplastically transformed cells, and cells with non-self antigens. Cytotoxic T cells and NK...