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Potentially reversible acute cerebellar toxicity associated with Minnelide
Sara Khanipour Roshan1, Anthony D Spano2, Alexander M McKinney3
1Department of Radiology, Division of Neuroradiology, University of Minnesota, 420 Delaware St. SE, Minneapolis, MN, 55455, USA. skhanipo@umn.edu.
Neuroradiology
|March 18, 2017
Summary
Minnelide, an experimental cancer drug, can cause reversible acute cerebellar toxicity (REACT). This study details two cases, highlighting a unique MRI pattern of cerebellar cortical involvement.
Area of Science:
- Neuro-oncology
- Radiology
- Clinical Pharmacology
Background:
- Minnelide is an experimental antineoplastic agent undergoing Phase 1 clinical trials for pancreatic and gastrointestinal malignancies.
- Cerebellar toxicity is a known potential side effect of some chemotherapeutic agents.
Observation:
- Two patients undergoing Minnelide treatment developed reversible acute cerebellar toxicity (REACT).
- Both patients had advanced metastatic cancer and were enrolled in a Minnelide Phase 1 clinical trial.
- Initial MRI revealed FLAIR hyperintensity and restricted diffusion in the cerebellar cortex.
Findings:
- The observed radiological pattern in Minnelide-induced REACT was isolated cerebellar cortical involvement.
- This pattern is distinct from other known cerebellotoxic agents.
- Symptoms and most imaging findings showed resolution on follow-up MRI.
Implications:
- This study documents an uncommon radiologic presentation of Minnelide-induced cerebellar toxicity.
- Increased physician awareness of Minnelide's potential neurotoxicity and its characteristic imaging findings is crucial.
- Early recognition and management may be facilitated by understanding this specific radiological pattern.
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