China
Africa
Explore chapters and articles related to this topic
Drug side effects on the distal phalanx
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Ibrutinib, a targeted therapy, is effective in the treatment of chronic lymphocytic leukemia and B-cell malignancies. Brittle are the most commonly reported nail-related side effect. Paronychial inflammation and periungual granulation have been recently described. The patient, a 40-year-old woman, was prescribed boric acid soak and topical corticosteroids; however, she was lost to follow-up (Yorulmaz and Yalcin 2020).
Small-Molecule Targeted Therapies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
The most serious side effects caused by ibrutinib include liver disorders (e.g., increased serum creatinine), blood abnormalities (e.g., thrombocytopenia, neutropenia, and anemia), GI disturbances (i.e., dry mouth, stomatitis, dyspepsia, indigestion, abdominal pain, nausea, vomiting, diarrhea, and constipation), and problems with lung function (e.g., dyspnea and pneumonia). Ibrutinib is not recommended for use in pregnancy, so contraception should be used during and for three months after stopping treatment.
Case 10
Published in Atul B. Mehta, Keith Gomez, Clinical Haematology, 2017
This condition responds poorly to therapy and is usually rapidly progressive. Treatment approaches in CLL have evolved rapidly. Advanced disease may respond to treatment with the anti-CD20 monoclonal antibody rituximab in combination with intensive chemotherapy – for example, R plus fludarabine and cyclophosphamide. Other monoclonals, for example, ofatumumab may also have a role. Ibrutinib is an orally administered, highly potent, selective and irreversible small-molecule inhibitor of Bruton's tyrosine kinase (Btk), an important component of the B-cell receptor signalling pathway. It has recently been licensed for patients with CLL who have relapsed. It has activity both as a single agent and in combination with monoclonals and chemotherapy. Venetoclax is a new agent that targets the BCL2 protein and has activity in refractory CLL. Venetoclax targets the BCL2 protein and has demonstrated activity in relapsed and refractory CLL.
Recurrent Uveitis Related to Ibrutinib for Treatment of Chronic Lymphocytic Leukemia
Published in Ocular Immunology and Inflammation, 2022
Parsa Mehraban Far, Jacob Rullo, James Farmer, Todd Urton
Ibrutinib, an irreversible inhibitor of Bruton’s kinase which plays an important role in B cell signaling, is a small molecule receptor tyrosine kinase inhibitor used for the management of B-cell malignancies.1 Ibrutinib is widely viewed as a safe agent, although recent reports have widened this drug’s adverse event profile, making the management of patients on ibrutinib more challenging.2 Ibrutinib has the potential to cross the blood-brain barrier and blood-ocular barrier to enter ocular structures such as the anterior chamber.3 Despite this, only a handful of papers to date have examined the ocular toxicities that accompany ibrutinib use.3–5 In this report, we present a case of recurrent sclerouveitis in a chronic lymphoid leukemia (CLL) patient who was successfully treated on ibrutinib and entered remission. This case identifies sclerouveitis as a potential adverse drug reaction associated with ibrutinib, highlighting a possible role for regular ophthalmic consultation in these patients, and prompt management of sclerouveitis if it is encountered as it may be severe and vision threatening.
Zanubrutinib for the treatment of adults with Waldenstrom macroglobulinemia
Published in Expert Review of Anticancer Therapy, 2022
Shayna Sarosiek, David Sermer, Andrew R. Branagan, Steven P. Treon, Jorge J. Castillo
Subsequently, an open-label subset of the iNNOVATE trial (Arm C) evaluated the use of ibrutinib in patients with rituximab-refractory WM (Table 1) [25]. Thirty-one patients that had relapsed within 12 months or had not achieved a minor response to rituximab therapy were enrolled. Ibrutinib was administered at 420 mg orally once daily until disease progression or unacceptable toxicity. The ORR was 90% with 71% of patients achieving a major response. Long-term follow-up at a median of 58 months revealed a median PFS of 39 months with a 60-month PFS rate of 40%. The median PFS was not reached in patients with MYD88L265PCXCR4WT, and it was 18 months in patients with MYD88L265PCXCR4MUT disease [18]. The median overall survival (OS) was not reached. Eighty-one percent of patients had a grade ≥3 adverse event, the most common of which were infections, neutropenia, hypertension, anemia, thrombocytopenia, and diarrhea (Table 2). No atrial fibrillation was reported in this study.
Acalabrutinib: a bruton tyrosine kinase inhibitor for the treatment of chronic lymphocytic leukemia
Published in Expert Review of Hematology, 2022
Anna Wolska-Washer, Tadeusz Robak
The question emerged whether acalabrutinib could be used in patients who develop intolerance to ibrutinib and require ongoing treatment for CLL. In a phase 2 multi-center clinical trial, 60 patients who were intolerant of ibrutinib and were not eligible for purine analog treatment were treated with acalabrutinib [45]. Ibrutinib intolerance was defined as persistent grade 3/4 AEs despite optimal supportive care, or grade 2 AEs that would continue for at least two weeks or recurred at least twice, despite ibrutinib-dose reduction or interruption. To avoid any confounding data associated with the influence of other medications, the most recent therapy before acalabrutinib was ibrutinib. The median ibrutinib treatment duration was 5.7 months, with 15 (25%) patients on ibrutinib for less than two months. The subsequent therapy with acalabrutinib resulted in only two discontinuations (due to lung and endometrial cancer). The most common AEs leading to ibrutinib discontinuation were atrial fibrillation, diarrhoea, arthralgia, and rash (in 23%, 12%, 10%, and 10% of patients, respectively). The median time from ibrutinib withdrawal to the start of acalabrutinib therapy was 7.5 months, and the median time on acalabrutinib was 32 months (range 0.3–47.4). Forty-eight percent of patients (n = 29) remained on acalabrutinib at a median follow-up of 34.6 months. The most common reason for treatment discontinuation was PD (23%) and AEs (17%).