In a nutshell
This review summarizes the common adverse effects of everolimus (afinitor) treatment and covers the recommend management of each of these.
Some background
Everolimus is a drug sometimes used to treat hormone receptor positive (HR+) breast cancer patients in addition to standard hormonal treatment. Everolimus inhibits the immune system, and may slow the progression of breast cancer. However, it can also cause a number of unwanted side effects.
Methods & findings
The most common side effects of everolimus treatment are stomatitis (mouth ulcers), rash, hyperglycemia (high blood sugar levels), hyperlipidemia (high cholesterol levels), fatigue, myelosuppression (reduced blood cell production), and pneumonitis (inflammation of the lungs).
Stomatitis occurs in up to 81% of patients but is easily treated with dexamethasone and miconazole applied to the skin. Rash occurs in up to 44% of patients and can be treated with exfoliation and antibiotics. Hyperglycemia occurs in up to 17% of patients. Diabetic patients receiving everolimus should also be treated with metformin and ensure their diabetes is well controlled. Hyperlipidemia occurs in up to 16% of patients and can be treated with one or more cholesterol-lowering medications. Fatigue occurs in up to 33% of patients and should be treated with nutritional, physical, and psychological support. Myelosuppression can occur in up to 69% of patients. In serious cases, everolimus should be paused and resumed at a lower dose. Pneumonitis is relatively uncommon (12-17% of patients) but can appear without symptoms, so patients should be monitored closely if any suspicion arises.
Generally, everolimus can be continued when side effects are mild, but may need to be paused and resumed at a lower dose if side effects are more severe.
The bottom line
The majority of everolimus side effects are mild, but treatment is important to ensure patient health, quality of life and compliance with treatment.
The fine print
One of the authors of this review has worked as a consultant for Novartis, who manufactures everolimus (afinitor).
What’s next?
Consult with your physician if you are experiencing any unwanted side effects to everolimus treatment.
Published By :
Breast Cancer Research and Treatment
Date :
Aug 02, 2013
