Radiomètre hyperfréquence La détection de l’émission propre constitue a de ce rayonnement dans le plasma dépend de la distribution de l’indice de réfraction. donné lieu à peu de recherches, ou du moins à peu de publications (Letarte. J Letarte’s 83 research works with citations and reads, including: Resultats du traitement a long terme d’un garcon de 7 ans dont l’activite ornithine .. to evaluate the cardiac dimensions and various indices of myocardial function . Suivre. Dominic Letarte Adresse e-mail validée de – Page d’accueil E Merlo, D Letarte, G Antoniol F Gauthier, D Letarte, T Lavoie, E Merlo.

Author: Taur Akinogis
Country: Chile
Language: English (Spanish)
Genre: Software
Published (Last): 22 December 2015
Pages: 342
PDF File Size: 16.90 Mb
ePub File Size: 15.26 Mb
ISBN: 810-4-11845-676-3
Downloads: 27068
Price: Free* [*Free Regsitration Required]
Uploader: Zugami

Crizotinib should be used with caution in patients with a predisposition to QT prolongation or in those on concomitant QT-prolonging medications.

The exact mechanism of this phenomenon is not known.

One approach to overcoming resistance is the development of next-generation Alk inhibitors However, liver enzyme elevation can occur letafte on as well. Although ALK had previously been identified in subsets of anaplastic large-cell lymphomas 3 and inflammatory myofibroblastic tumours 4its identification in nsclc was what prompted the investigation of Alk inhibition as a therapeutic strategy. A number of reports describe patients who continued to respond systemically, but who progressed letagte the cns 17 Proactive management of ae s helps to optimize the therapeutic index of targeted therapies and enhances quality of life for patients.

Peripheral Edema Peripheral edema occurs in up to one third of patients taking crizotinib, being the main cumulative effect of this agent Table i. Peripheral edema occurs in up to ,etarte third of patients taking crizotinib, being the main cumulative effect of this agent Table i. A phase iii study in advanced ALK -positive nsclc progressing on a first-line platinum-based doublet compared crizotinib with standard second-line chemotherapy using pemetrexed or docetaxel profile The exact mechanism of this difference has not been fully letafte.


Given the prevalence of nsclcestimates suggest that several hundred patients with advanced ALK -positive nsclc will be diagnosed annually in Canada 5. Copyright Multimed Inc. Articles from Current Oncology are provided here courtesy of Multimed Inxice. Despite the impressive activity of crizotinib, resistance is generally inevitable 11 Concomitant medication list, physical exam heart rate and blood pressureelectrocardiogram, electrolytes.

The present review focuses on the management of treatment-related ae s associated with Alk inhibitors. It focuses on nsclcgiven that most of the available data relate to that disease and that the other populations in which Alk inhibitors have shown benefit are relatively rare tumours.

Caution should be exercised with the concomitant use of CYP3A-metabolized drugs with narrow therapeutic indices, especially when associated with cardiac arrhythmias The mechanism is unknown, although edema is also an effect seen with other Met inhibitors Most patients who experience liver enzyme elevation do so within the first 2 months of treatment.

Occurrences are typically grade 1 or 2 8. Although Alk inhibitors such as crizotinib are well tolerated, there is a potential for adverse events to occur. Tables ii and iii detail parameters to monitor and dose modifications.

Until further data emerge, men starting on crizotinib should have baseline testosterone levels determined in an early-morning blood sample. If co-administration of such drugs is unavoidable, monitoring should occur more frequently. A global phase ii lerarte in a similar patient population profile confirmed that remarkable clinical activity 9.

A practical question about ability to drive often comes up at crizotinib start. In patients treated on profiledee visual symptom assessment questionnaire was completed on day 1 of each cycle.

Proactive monitoring, treatment, and education concerning those adverse events will help to optimize the therapeutic index of the drugs. In Canada, patients are currently screened for ALK by immunohistochemistry, with fluorescence in situ hybridization used for confirmation.

Managing treatment–related adverse events associated with Alk inhibitors

The use of targeted therapies for subsets of molecularly-defined cancers has been a paradigm shift in cancer treatment. Find articles by N. Given the effectiveness of targeted lefarte, patients will often be taking the agents for long periods of time. In profile andsevere pneumonitis was seen in 1.


Based on those findings, letartte is important to monitor liver enzymes while patients are on crizotinib, especially within the first 2 months. A pooled analysis letarre profile and that included more than patients treated with crizotinib calculated the overall incidence of liver enzyme abnormalities Table iv Transaminase elevations are usually reversible, and patients are typically able to resume treatment at the same or a lower dose.

Mechanisms of acquired crizotinib resistance in ALK-rearranged lung cancers.

Hypogonadism occurs quite commonly in patients with advanced cancer, and it is often underdiagnosed and rarely treated Cardiac Effects Crizotinib is associated with two main cardiac effects: Symptoms of liver dysfunction should prompt assessment for possible drug-induced liver injury. Several excellent induce on the current understanding of ALK -positive nsclc and approaches to overcoming resistance are available 13 That study demonstrated significant improvements in response rate and progression-free survival in favour of crizotinib, but no overall survival benefit was observed, presumably because of crossover.

Every 2 weeks during the first 2 months, then monthly and as clinically indicated More frequent testing for grade 2, 3, or 4 elevation. However, in patients with unexplained pulmonary symptoms, crizotinib-induced pneumonitis has to be considered in the differential diagnosis. In patients who have symptoms of hypogonadism, serum testosterone should be checked.

Gaël Letarte – Citations Google Scholar

Canadian Cancer Society; Dosing The recommended dose of crizotinib is mg taken orally twice daily. National Center for Biotechnology InformationU. In the profile trial, a heart rate decrease by a mean of