Levy A, Hollebecque A, Bourgier C, Loriot Y, Guigay J, Robert C, Delaloge S, Bahleda R, Massard C, Soria JC, Deutsch E, et al.
European journal of cancer (Oxford, England : 1990). Date of publication 2013 May 1;volume 49(7):1662-8.
1. Eur J Cancer. 2013 May;49(7):1662-8. doi: 10.1016/j.ejca.2012.12.009. Epub 2013
Jan 8.
Targeted therapy-induced radiation recall.
Levy A(1), Hollebecque A, Bourgier C, Loriot Y, Guigay J, Robert C, Delaloge S,
Bahleda R, Massard C, Soria JC, Deutsch E.
Author information:
(1)Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France.
antonin.levy@igr.fr
INTRODUCTION: Radiation recall (RR) is an acute inflammatory reaction confined to
previously irradiated areas after the administration of various pharmacological
agents. A diverse range of chemotherapies has been associated with RR but no case
series with targeted therapies (TT) has been reported.
PATIENTS AND METHODS: From a database of 346,933 cancer patients ≥18 years
treated at Institut Gustave Roussy between June 1986 and August 2012, clinical
data and the pattern of treatment of TT-induced RR were collected. Results were
compared with those of prior TT-induced RR publications.
RESULTS: Sixteen patients with different tumour types were diagnosed with RR
observed in the heart, bladder, salivary glands, skin and gastrointestinal tract.
The median duration of RR was 1.7 weeks (range: 0.1-13.7) and median time to
onset from TT to RR was 16.9 weeks (range: 1-86.9). TT consisted of inhibitors of
the mammalian target of rapamycin (mTOR) (n=5), endothelial growth factor
receptor (EGFR) (n=2), integrin (n=2), histone deacetylase (HDAC) (n=2), cell
division cycle 7 (CDC7) (n=1), insulin-like growth factor 1 receptor (IGFR1)
(n=1), cyclin-dependent kinase (CDK) (n=1), BRAF (n=1) and a vascular disrupting
agent (VDA) (n=1). Thirteen incriminated TT (81%) were evaluated during early
clinical trials and RR led to discontinuation of TT in six patients. All patients
had previously received radiotherapy at a median biologically effective dose
(BED) of 47 Gy (range: 20-70). The median interval from radiation to TT was 30
months (range: 0.3-363). Immunohistochemical analysis of skin biopsy specimens
did not show any transforming growth factor-beta (TGF-β) activation. TT-induced
RR characteristics in our population were comparable to those of the nine other
cases previously reported in the literature.
CONCLUSION: This is the largest case series ever reported on TT-induced RR. RR
could be a potential dose-limiting toxicity in early clinical trials. Research is
warranted to further understand the exact pathophysiology of this rare but
clinically relevant phenomenon.
Copyright © 2012 Elsevier Ltd. All rights reserved.
DOI: 10.1016/j.ejca.2012.12.009
PMID: 23312391 [Indexed for MEDLINE]
