Everolimus
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Oral mucositis following off label use: case report A 59-year-old man developed oral mucositis following off label treatment with everolimus for laryngeal neuroendocrine tumour. The man presented to the endocrinology outpatient clinic due to complaints dyspnoea, dysphagia and a left lateral cervical mass that appeared 2 years prior. His medical history was significant for smoking (one pack of cigarettes/day since the age of 18 years), hypertension and resolved hepatitis-C. Examinations showed left supraclavear lymphadenopathy. Therefore, his treatment was started with octreotide long acting release 30mg every 28 days (off label treatment); however, disease progression was noted. After 9 months of treatment, new painful cutaneous lesions were noted, which required morphine therapy. A multidisciplinary evaluation proposed total thyroidectomy for cytological diagnosis of TIR3B, associated to cervical lymphadenectomy and cutaneous metastases resection aimed to tumour debulking and pain relief. Histological examination of the resected samples led to the diagnosis of grade II calcitonin-secreting laryngeal neuroendocrine neoplasm. Significant improvement was noted after the surgical procedure, and morphine therapy was terminated. After 2 months, disease progression was again noted; hence, treatment was started with everolimus 10 mg/day (off label treatment) [route not stated]. After 3 weeks of everolimus treatment, he developed grade III oral mucositis characterised by pain and nutritional impairment. Consequently, the man’s everolimus therapy was discontinued, and he was treated with unspecified antifungals. Thereafter, everolimus was re-initiated at a reduced dose of 5mg and was then increased to 10mg. He tolerated the therapy well and showed improvement in underlying condition. Feola T, et al. Laryngeal Neuroendocrine Tumor With Elevated Serum Calcitonin: A Diagnostic and Therapeutic Challenge. Case Report and Review of Literature. Frontiers in Endocrinology 11: Jul 2020. Available from: URL: http://doi.org/10.3389/fendo.2020.00397 803497639
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Reactions 22 Aug 2020 No. 1818
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