Everolimus and adverse events

This paper reviewed adverse events associated with treatment of breast cancer with everolimus (Afinitus).

Everolimus is used in postmenopausal patients for advanced breast cancer treatments. The drug has been approved for use in patients with hormone receptor positive (the presence of the estrogen and/or progesterone receptor protein) and human epidermal growth factor 2 negative (the absence of HER2 protein) breast cancer. Overall, a continuous dosage of 10 mg of everolimus can be tolerated. However, adverse events (unfavorable symptoms or disease that may or may not be considered related to the medical treatment) can occur. The authors studied various adverse events associated with everolimus.

Stomatitis is an adverse event that refers to an inflamed mouth. One study studied patients who received everolimus plus exemestane (Aromasin). It was found that more than a third of stomatitis events were reported in the first 2 weeks after starting treatment. The average incidence of stomatitis during everolimus treatment is 44%.

Noninfectious pneumonitis refers to an inflammation of the lungs. Half of all pneumonitis occurred within the first 24 weeks after treatment was started. From various studies, the overall rate of noninfectious pneumonitis was 41%. In another study, 75% of patients who developed noninfectious penumonitis recovered at an average of 5.4 weeks. 

Everolimus can also be associated with infections. The overall incidence of infections was 50% in patients receiving everolimus. The overall incidence of infections was 25% in patients not receiving everolimus. When infections occur, everolimus therapy should be discontinued or paused.

Hyperglycemia (high blood glucose levels) and hyperlipidemia (high levels of fats) can be caused by everolimus. The incidence of hyperglycemia in advanced breast cancer was 14%. Patients treated with everolimus had a 24-44% higher incidence of hyperlipidemia compared to patients not treated with everolimus.

Rash is also associated with everolimus. In studies, the incidence of rash ranged from 29% to 49%. The majority of rash events disappeared without any treatment. 

The authors concluded that everolimus is an effective treatment option with manageable toxicity. Patient education can help to reduce the impact of adverse events. 

Consult with your doctor on the risks of everolimus and how to reduce these risks.