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Pazopanib-induced chylothorax in a patient with renal cell carcinoma

Bahadir Koylu1, Fatih Tekin2, Burak Yasin Aktas3

  • 1Department of Internal Medicine.

Anti-Cancer Drugs
|August 13, 2021
PubMed

Insights

Pazopanib, a treatment for advanced kidney cancer, can cause chylothorax, a rare fluid buildup. This adverse effect resolved after discontinuing the medication.

Area of Science:

  • Oncology
  • Pharmacology
  • Medical Case Reports

Background:

  • Pazopanib is an oral multi-kinase inhibitor used for advanced renal cell carcinoma (RCC).
  • It functions as an anti-angiogenic agent, targeting vascular endothelial growth factor receptors (VEGFR)-2 and VEGFR-3.
  • VEGFRs play a crucial role in lymphangiogenesis.

Observation:

  • A patient with advanced RCC developed asymptomatic left-sided chylothorax during pazopanib treatment.
  • Chylothorax manifested after 16 months of therapy and was diagnosed via thoracentesis at 22 months.
  • Other potential causes for chylothorax were systematically excluded.

Findings:

  • The development of chylothorax was attributed to pazopanib, with an 'Adverse Drug Reaction Probability Scale' score indicating a 'probable' relationship.
  • Significant regression of chylothorax was observed within 5 weeks of discontinuing pazopanib therapy.

Implications:

  • This case highlights chylothorax as a potential, albeit rare, adverse effect of pazopanib in advanced RCC patients.
  • Clinicians should consider pazopanib-induced chylothorax in patients presenting with this condition.
  • Monitoring for and prompt management of this adverse event may improve patient outcomes.

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