• PDF / 170,641 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 112 Downloads / 157 Views

DOWNLOAD

REPORT

---

1 S

Various toxicities following off-label use: 4 case reports A case series described 4 women aged 45–74 years, who developed neutropenia, anaemia, onychopathy, fatigue, constipation, neuropathy, nausea, alopecia, dyschromia or neurotoxicity during off-label therapy with paclitaxel and trastuzumab for extramammary Paget’s disease of the vulva [not all dosages stated; routes, times to reactions onsets and outcomes not stated]. Case 1: A 45-year-old woman started receiving off-label therapy with paclitaxel 80 mg/m2 every week and trastuzumab 2 mg/kg every week since November 2015, for a 16-year history of intra-epithelial Paget’s disease of the vulva and anal/perineal region, with an underlying adenocarcinomatous component infiltrating the reticular dermis. However, she subsequently developed treatmentrelated toxicities in the form of grade 3 neutropenia, alopecia, dyschromia and paclitaxel-related neuropathy. The dose of paclitaxel was reduced to 80% in May 2016 due to the grade 3 neutropenia. Case 2: A 74-year-old woman, who had intra-epithelial vulvar Paget’s disease for 6 years, started receiving off-label therapy with weekly paclitaxel and trastuzumab in February 2018. She received 22 cycles until July 2018, during which, she developed treatmentrelated toxicities in the form of grade 1–2 onychopathy, grade 2 anaemia, alopecia, dyschromia and paclitaxel-related neuropathy. Her disease eventually progressed, and she was unable to undergo further treatment due to her low performance status. She passed away in January 2019 [immediate caused of death not stated]. Case 3: A 67-year-old woman, who was diagnosed with intra-epithelial vulvar Paget’s disease in May 2013, started receiving offlabel therapy with paclitaxel and trastuzumab in June 2018 for 18 weeks. However, she subsequently developed treatment-related toxicities in the form of grade 2 neurotoxicity, grade 1 fatigue, grade 1 constipation, grade 1 nausea, grade 1 alopecia, grade 1 anaemia, dyschromia and paclitaxel-related neuropathy. The dose of paclitaxel was reduced to 80% due to the grade 2 neurotoxicity and fatigue. Her disease eventually progressed, and she passed away in March 2020 [immediate caused of death not stated]. Case 4: A 58-year-old woman, whose medical history was notable for misdiagnosed intra-epithelial vulvar Paget’s disease for 12 years, started receiving off-label therapy with trastuzumab every 3 weeks since February 2019. Due to worsening of the locoregional situation, paclitaxel was added in November 2019. Thereafter, her condition improved. However, she subsequently developed treatment-related toxicities in the form of grade 2 neurotoxicity, alopecia, dyschromia and paclitaxel-related neuropathy. Bartoletti M, et al. Human epidermal growth factor receptor-2 (HER2) is a potential therapeutic target in extramammary Paget’s disease of the vulva. International Journal of 803514569 Gynecological Cancer 30: 1672-1677, No. 11, 30 Sep 2020. Available from: URL: http://doi.org/10.1136/ijgc-2020-001771

0114-9954/20/1830-0001/$14.95 Adis © 2