Cabozantinib
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Gastropleural fistula: case report A 55-year-old woman developed gastropleural fistula during treatment with cabozantinib for metastatic renal cell carcinoma (RCC). The woman who had metastatic RCC had been receiving treatment with cabozantinib chemotherapy and radiation [route and dosage not stated]. She also had left radical nephrectomy. Eventually, she presented with a one-week history of shortness of breath and left pleuritic chest pain. A chest X-Ray showed a new left pleural effusion, whereas chest CT showed a loculated left-sided pleural effusion. The pleural fluid analysis was consistent with empyema. The culture of pleural fluid grew Candida krusei and Lactobacillus species. She then received unspecified antibacterial therapy and a chest tube was inserted. Repeat chest CT showed inflammation and gas in the left upper abdomen with possible trans-diaphragmatic fistula. For further evaluation, she received methylthioninium-chloride orally. Endoscopic examination confirmed a 1.5cm gastropleural fistula secondary to cabozantinib treatment with attempted closure. Follow up CT scan showed persistent oral contrast in the pleural space. At the time of the report, she was under consideration for surgical candidacy [duration of treatment to reaction onset and outcome not stated]. Kramer D, et al. The dye don’t lie: A case of gastropleural fistula. American Journal of Respiratory and Critical Care Medicine 199: (plus poster) abstr. A6406, No. 9, May 803447367 2019. Available from: URL: https://doi.org/10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A6406 [abstract]
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Reactions 18 Jan 2020 No. 1787
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