pneumothorax during pazopanib therapy: STS

[D.ap]

Titled:

Pneumothorax as adverse event in patients with
lung metastases of soft tissue sarcoma treated
with pazopanib: a single reference centre case
series


Background: Recently, the phase III PALETTE study introduced pazopanib (Votrient®) as treatment for adult patients
with locally advanced or metastatic non-liposarcoma soft tissue sarcoma after prior treatment with doxorubicin
and/or ifosfamide. Pneumothorax was reported as adverse event in 8 of 246 treated patients (3.3%) in that study.
This case series presents the incidence and clinic of this complication in the Leiden University Medical Centre.
Cases: Forty-three patients were treated with pazopanib of which six patients (14.0%) developed a pneumothorax.
These six patients were treated for malignant peripheral nerve sheath tumour, angiosarcoma, synovial sarcoma,
fibromyxomatoid sarcoma, pleomorphic sarcoma and endometrial stromal sarcoma. All six patients had subpleural
pulmonary or pleural metastases at the start of pazopanib and the pneumothorax developed during or shortly after
treatment with pazopanib and was difficult to treat.
Discussion: The incidence reported by us is higher than the incidence in the PALETTE study. Trials with pazopanib
in renal cell carcinoma, urothelial carcinoma and cervix carcinoma did not report pneumothorax as an adverse
event, suggesting pneumothorax as a specific adverse event in soft tissue sarcoma patients treated with pazopanib.
This may be related to the fact that there is often pleural metastatic involvement and cystic degeneration due to
pazopanib treatment may add to the risk.
Conclusion: The risk of an, often difficult to treat, pneumothorax during pazopanib therapy should be discussed
with the patient before initiation of treatment for a pulmonary metastasized sarcoma and physicians should be
alert to the occurrence of such an event.



http://www.clinicalsarcomaresearch.com/ ... 9-4-14.pdf

Defintion of pneumothorax :

http://medical-dictionary.thefreedictio ... eumothorax

My thought is, and I am by no means a doctor, that we have friends that are :

a) compromised through surgeries of the lungs. Weakened by blunt force

b) have large and small tumors that may be at risk for the pazonib necrotic theory of possible cause, the 14% , that may be needed to be looked at for possible complications. Especially outside of the controlled trials

[D.ap]

There are several types of pneumothorax

Secondary types are a little tricky to combat medically as I understand

Please go into your treatment Pro actively NOT reactively.

http://www.drugs.com/cg/spontaneous-pneumothorax.html

Much love
Debbie

[Olga]

Yes, it is a potential (although rare) complication that sarcoma patients taking pazopanib (or other TKI) have to know about. Pneumothorax is a very serious situation that could be lethal if not resolved fast. Shortness of breath, pain when inhale or exhale, pain in the chest area etc. in a patient with known lung metastases should lead to immediate visit to ER - chest X-Ray will show if the lungs are inflated.

[Bonni Hess]

Dear Debbie and Olga, This is critically important information that every patient considering Pazopanib treatment should be aware of and should discuss with their oncologist prior to beginning a Pazopanib treatment regimen. As with any treatment, the patient and the patient's family should be as well researched and as knowledgeable as possible about the possible risks, side effects, and documented results of any systemic treatment that is being considered as a potential treatment option. Although it appears that Pazopanib caused/related pneumothorax is relatively rare and I am personally not aware of any ASPS Pazopanib patients who have experienced a pneumothorax during their Pazopanib treatment, it is certainly a risk to be aware of, as well as the symptoms of pneumothorax which require immediate medical attention and treatment. Having experienced pneumothorax with Brittany following her lung RFA procedure in Pittsburgh, I know that it can be very frightening and painful, and in Brittany's case it required emergency hospitalization, insertion of a tube into the lung to reinflate the lung, and a couple of days in the hospital. With special caring thoughts and continued Hope, Bonni