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Enema of Traditional Chinese Medicine for Patients with Severe Acute Pancreatitis
Published on: January 27, 2023
Sorafenib-Induced Acute Pancreatitis in a Patient with Differentiated Thyroid Cancer
Laura Ximena Kattah Martinez1, Lisseth Fernanda Marín Carrillo1, Leonardo Rojas Melo1
1Pontificia Universidad Javeriana, Bogotá, Colombia.
Background:
Sorafenib is a tyrosine kinase inhibitor approved for the treatment of metastatic renal cell carcinoma, hepatocellular carcinoma, and recently for radioactive iodine (RAI)-refractory metastatic differentiated thyroid carcinoma (DTC). Several side effects have been described including alterations in amylase and lipase levels. Nonetheless, only a few cases of pancreatitis during renal carcinoma and hepatocellular carcinoma treatment have been described.
Objective:
To describe the first case report of sorafenib-induced acute pancreatitis during the treatment of thyroid carcinoma.
Methods And Results:
In a 60-year-old Latin woman with RAI-refractory papillary thyroid carcinoma, T4bN1bM1, sorafenib was indicated due to locally recurrent, metastatic, and progressive lung involvement without iodine uptake. Therapy was initiated (200 mg) every 8 h. Three days after starting the medication, abdominal pain, nausea, and emesis appeared. A blood test revealed elevated amylase (343 U/L RV: 28-100) and lipase (1,969 U/L RV: 23-300) levels, but no other findings, confirming acute mild pancreatitis. Hypertriglyceridemia, hypercalcemia, and alcohol and biliary etiologies were ruled out and sorafenib-acute pancreatitis was concluded. Two weeks later, sorafenib was resumed without recurrence. To date, this is the tenth sorafenib-related pancreatitis report and the first in a patient with RAI-refractory metastatic DTC.
Conclusions:
Sorafenib-acute pancreatitis may develop in patients with RAI-refractory thyroid cancer. This adverse event seems to be inde-pendent of the treatment duration and administered dose. Resuming the medication with an adjusted dose after pancreatitis resolution may be safe.
Insights
Sorafenib can cause acute pancreatitis in patients with radioactive iodine-refractory differentiated thyroid cancer. This side effect appears unrelated to dose or duration, and restarting sorafenib may be safe after recovery.
Area of Science:
- Oncology
- Pharmacology
- Gastroenterology
Background:
- Sorafenib is a tyrosine kinase inhibitor used for metastatic renal cell carcinoma, hepatocellular carcinoma, and differentiated thyroid carcinoma (DTC).
- While sorafenib can alter amylase and lipase levels, pancreatitis is rarely reported in renal cell carcinoma and hepatocellular carcinoma patients.
- Few cases of sorafenib-induced pancreatitis exist, particularly in thyroid cancer patients.
Purpose of the Study:
- To report the first case of sorafenib-induced acute pancreatitis in a patient with radioactive iodine-refractory metastatic differentiated thyroid carcinoma.
- To highlight a potential adverse effect of sorafenib in thyroid cancer treatment.
Main Methods:
- A case report of a 60-year-old woman with advanced, RAI-refractory papillary thyroid carcinoma treated with sorafenib.
- Monitoring of symptoms, laboratory values (amylase, lipase), and exclusion of other pancreatitis etiologies.
- Observation of pancreatitis recurrence after dose adjustment and medication reinitiation.
Main Results:
- The patient developed acute mild pancreatitis three days after initiating sorafenib (200 mg every 8 h).
- Elevated amylase and lipase levels confirmed pancreatitis; other causes were ruled out.
- Sorafenib was resumed two weeks later without recurrence, suggesting potential safety with dose adjustment.
Conclusions:
- Sorafenib-induced acute pancreatitis is a possible adverse event in patients with RAI-refractory thyroid cancer.
- The occurrence of pancreatitis appears independent of sorafenib treatment duration and dose.
- Rechallenging with sorafenib at an adjusted dose after pancreatitis resolution may be a safe therapeutic option.
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