[Adverse cutaneous effects and quality of life in patients treated with mTOR inhibitors for renal carcinoma]

Ann Dermatol Venereol. 2013 May;140(5):353-62. doi: 10.1016/j.annder.2013.02.023. Epub 2013 Apr 6.
[Article in French]

Abstract

Background: Mammalian target of rapamycine (mTOR) inhibitors are being increasingly prescribed as antitumoural drugs, and associated adverse cutaneous effects are frequent but poorly described. The aim of this study was to describe such adverse effects and to assess the quality of life of patients experiencing them.

Patients and methods: Over a period of 18 months, 18 patients treated with mTOR inhibitors for renal carcinoma were included and 77 dermatological examinations performed. Wherever a cutaneous adverse event was present, quality of life was evaluated using the Skindex 30 questionnaire.

Results: Fifteen of the 18 patients included presented adverse cutaneous events, consisting of buccal ulcers (61.1%), xerosis (55.5%), distal onycholysis (50%), acneiform eruption (38.8%), paronychia (22.2%) and pruritus (22.2%). Buccal ulcerations and perionyxis had an especially marked impact on quality of life, which was greatest in terms of physical score (19%), followed by emotional (9%) and functional (6%) scores.

Conclusion: Cutaneous adverse effects of mTOR inhibitors are frequent and have a considerable impact on quality of life, particularly as regards physical scores. Dermatological examination appears useful to allow early management of cutaneous adverse effects and improve the quality of life of these patients.

MeSH terms

  • Acneiform Eruptions / chemically induced
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Renal Cell / drug therapy*
  • Drug Eruptions / etiology*
  • Drug Eruptions / psychology
  • Emotions
  • Everolimus
  • Female
  • Humans
  • Ichthyosis / chemically induced
  • Kidney Neoplasms / drug therapy*
  • Male
  • Middle Aged
  • Onycholysis / chemically induced
  • Paronychia / chemically induced
  • Prospective Studies
  • Pruritus / chemically induced
  • Quality of Life
  • Severity of Illness Index
  • Sirolimus / adverse effects
  • Sirolimus / analogs & derivatives*
  • Sirolimus / therapeutic use
  • Stomatitis, Aphthous / chemically induced
  • TOR Serine-Threonine Kinases / antagonists & inhibitors*

Substances

  • Antineoplastic Agents
  • temsirolimus
  • Everolimus
  • MTOR protein, human
  • TOR Serine-Threonine Kinases
  • Sirolimus