Vincristine/vismodegib

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Multiple toxicities: case report A 42-year-old woman developed possible pneumocystosis, pulmonary emboli, pulmonary toxicity and myelosuppression​ during treatment with vincristine, and she developed alopecia, dysgeusia and muscle cramps during treatment with vismodegib for systemic medulloblastoma metastases. The woman presented with headache and gait instability in January 2017. She was subsequently diagnosed with sonic hedgehog (SHH)-subgroup medulloblastoma. She was treated with surgery, followed by craniospinal radiotherapy during February–April 2017, and vincristine [route and dosage not stated]. However, the course of vincristine therapy was complicated by the development of possible pneumocystosis, pulmonary emboli, pulmonary toxicity and myelosuppression​. Later, in October 2018, she was diagnosed with a basal cell carcinoma of the right shoulder, which was surgically resected. She also complained of bone pain. Bone metastases were subsequently detected, which were thought to have resulted from the medulloblastoma. She underwent focal radiotherapy in January 2019, and in April 2019, she started receiving oral vismodegib 150mg daily. In January 2020, tests revealed significant improvement in the bone metastases; however, during the course of vismodegib therapy, she developed side effects in the form of alopecia, dysgeusia and muscle cramps. The woman’s treatment with vismodegib was discontinued in June 2020; subsequent analyses in July 2020 confirmed progression of multiple bone metastases. Thereafter, she started receiving temozolomide [duration of treatments to reactions onsets and outcomes not stated]. Climans SA, et al. Prolonged response to vismodegib in a patient with systemic medulloblastoma metastases. BMJ Case Reports 13: e236406, No. 10, 29 Oct 2020. Available from: URL: http://doi.org/10.1136/bcr-2020-236406 803520593

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Reactions 12 Dec 2020 No. 1834

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