When targeted therapy for cancer leads to ICU admission. RETRO-TARGETICU multicentric study

Bull Cancer. 2022 Sep;109(9):916-924. doi: 10.1016/j.bulcan.2022.04.014. Epub 2022 Jun 16.

Abstract

Purpose: To study prevalence of targeted therapy (TT)-related adverse events requiring ICU admission in solid tumor patients.

Methods: Retrospective multicenter study from the Nine-i research group. Adult patients who received TT for solid tumor within 3 months prior to ICU admission were included. Patients admitted for TT-related adverse event were compared to those admitted for other reasons.

Results: In total, 140 patients, median age of 63 (52-69) years were included. Primary cancer site was mostly digestive (n=27, 19%), kidney (n=27, 19%), breast (n=24, 17%), and lung (n=20, 14%). Targeted therapy was anti-VEGF/VEGFR for 27% (n=38) patients, anti-EGFR for 22% (n=31) patients, anti-HER2 for 14% (n=20) patients and anti-BRAF for 9% (n=5) patients. ICU admission was related to TT adverse events for 30 (21%) patients. The most frequent complications were interstitial pneumonia (n=7), cardiac failure (n=5), anaphylaxis (n=4) and bleeding (n=4). At ICU admission, no significant difference was found between patients admitted for a TT-related adverse event and the other patients. One-month survival rate was higher in patients admitted for TT adverse event (OR=5.733 [2.031-16.182] P<0.001).

Conclusions: Adverse events related to targeted therapy accounted for 20% of ICU admission in our population and carried a 16% one-month mortality. Outcome was associated with admission for TT related to adverse event, breast cancer and good performance status.

Keywords: Adverse event; ICU; Outcome; Solid tumours; Targeted therapy.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Intensive Care Units*
  • Middle Aged
  • Neoplasms* / drug therapy
  • Retrospective Studies
  • Survival Rate