Expert opinion on the metabolic complications of mTOR inhibitors.
Ann Endocrinol (Paris)
; 79(5): 583-590, 2018 Oct.
Article
em En
| MEDLINE
| ID: mdl-30144939
ABSTRACT
Using mTOR inhibitors (mTORi) as anticancer drugs led to hyperglycemia (12-50%) and hyperlipidemia (7-73%) in phase-III trials. These high rates require adapted treatment in cancer patients. Before initiating mTORi treatment, lipid profile screening should be systematic, with fasting glucose assay in non-diabetic patients and HbA1C in diabetic patients. After initiation, lipid profile monitoring should be systematic, with fasting glucose assay in non-diabetic patients, every 2 weeks for the first month and then monthly. The HbA1C target is≤8%, before and after treatment initiation in known diabetic patients and in case of onset of diabetes under mTORi. LDL-cholesterol targets should be adapted to general health status and cardiovascular and oncologic prognosis. If treatment is indicated, pravastatin should be prescribed in first line; atorvastatin and simvastatin are contraindicated. Fenofibrate should be prescribed for hypertriglyceridemia>5g/l resisting dietary measures adapted to oncologic status. In non-controllable hypertriglyceridemia exceeding 10g/l, mTORi treatment should be interrupted and specialist opinion should be sought.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Serina-Treonina Quinases TOR
/
Doenças Metabólicas
/
Antineoplásicos
Tipo de estudo:
Guideline
Aspecto:
Patient_preference
Limite:
Humans
Idioma:
En
Revista:
Ann Endocrinol (Paris)
Ano de publicação:
2018
Tipo de documento:
Article