Pazopanib-Induced Severe Acute Pancreatitis

Area of Science:

• Oncology
• Gastroenterology
• Pharmacology

Background:

• Pazopanib is an oral angiogenesis inhibitor targeting VEGFR, PDGFR, and c-Kit, approved for renal cell carcinoma and soft tissue sarcoma.
• Nonselective kinase inhibitors like sunitinib and sorafenib are known to cause acute pancreatitis.
• Few case reports exist on pazopanib-induced severe acute pancreatitis.

Observation:

• An 82-year-old female with cutaneous angiosarcoma developed pancreatic swelling and inflammation 3 months after starting pazopanib, initially without pain.
• Symptoms of nausea and appetite loss appeared 2 months later, with worsening pancreatic inflammation and elevated serum amylase/lipase.
• A pancreatic pseudocyst developed, requiring endoscopic ultrasound-guided drainage.

Findings:

• The patient was diagnosed with severe acute pancreatitis attributed to pazopanib treatment.
• Conservative management including pazopanib discontinuation did not resolve symptoms, necessitating pseudocyst drainage.
• The patient recovered fully after stent placement for the pancreatic pseudocyst.

Implications:

• Oncologists must be aware that pazopanib can induce severe acute pancreatitis, a potentially serious adverse event.
• Vigilant monitoring for pancreatitis is crucial in patients receiving pazopanib, especially those with risk factors or atypical presentations.
• Early recognition and appropriate management, including potential intervention for complications like pseudocysts, are vital for patient outcomes.