Skin Hypopigmentation in a Patient with Papillary Carcinoma Thyroid Treated with Sorafenib
DOI:
https://doi.org/10.17140/CSMMOJ-2-110Keywords:
Thyroid Carcinoma, Sorafenib, HypopigmentationAbstract
Sorafenib is an oral multikinase inhibitor approved for the treatment of advanced renal cell carcinoma, hepatocellular carcinoma and thyroid cancer. The dermatological side effects of sorafenib include palmar-plantar erythrodysesthesia, alopecia, skin rash, pruritus, xeroderma and erythema. Here we report a case of skin hypopigmentation related to sorafenib therapy. A 60 year old male with papillary carcinoma of thyroid with cervical lymph nodal metastasis, post thyroidectomy and Iodine-131 ablation therapy developed lung metastasis. As the lesions were not iodine avid, he was started on sorafenib. After 4 months of treatment with 800 mg/day he developed hypopigmentation of the skin, prominently on the forehead, neck, hands and feet. He was also having grade 2 mucositis, so dose was reduced to 400 mg/day. Later his disease progressed, so sorafenib was discontinued. However, the hypopigmented lesions persisted. Hypopigmentation as a potential side effect of sorafenib has rarely been reported in literature. Close collaboration between oncologists and dermatologists is needed to improve in the characterization and the management of cutaneous side effects of Sorafenib.
References
Bracarda s, Ruggeri EM, Monti M, et al. Early detection, prevention and management of cutaneous adverse events due to sorafenib: Recommendations from the sorafenib working group. Crit Rev Oncol Hematol. 2012; 82: 378-386. doi: 10.1016/j. critrevonc.2011.08.005
Wilhelm SM, Adnane L, Newell P. Preclinical overview of sorafenib, a multikinase inhibitor that targets both Raf and VEGF and PDGF receptor tyrosine kinase signaling. Mol Cancer Ther. 2008; 7: 3129-3140. doi: 10.1158/1535-7163.MCT-08-0013
Capdevila J, Iglesias L, Halperin I, et al. Sorafenib in metastatic thyroid cancer. Endocrine Related cancer. 2012; 19: 209-216.
Llovet JM, Ricci S, Mazzaferro V, et al. SHARP Investigators Study Group. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008; 359: 378-390. doi: 10.1056/NEJMoa0708857
Hutson TE, Bellmunt J, Porta C, et al. Long-term safety with sorafenib in advanced renal cell carcinoma:follow-up of patients from phase III TARGET. Eur J Cancer. 2010; 46: 2432-24340. doi: 10.1016/j.ejca.2010.06.121
Naito S, Tsukamoto T, Murai M, Fukino K, Akaza H. Overall survival and good tolerability of long-term use of sorafenib after cytokine treatment: final results of a phase II trial of sorafenib in Japanese patients with metastatic renal cell carcinoma. BJU Int. 2011; 108: 1813-1819. doi: 10.1111/j.1464-410X.2011.10281.x
Porta C, Paglino C, Imarisio I, Bonomi L. Uncovering Pandora’s vase: The growing problem of new toxicities from novel anticancer agents.The case of sorafenib and sunitinib. Clin Exp Med. 2007; 7: 127-134. doi: 10.1007/s10238-007-0145-8
Hussain SZ, Asghar A, Ikram M, Islam N. Development of skin hypopigmentation in a patient with metastatic papillary carcinoma thyroid treated with Sorafenib. BMC Endocr Disord. 2013. 13: 29. doi: 10.1186/1472-6823-13-29
Lacouture ME, Wu S, Robert C. Evolving strategies for the management of hand-foot reaction associated with the multitargeted kinase inhibitors sorafenib and sunitinib. Oncologist. 2008; 13: 1001-1011. doi: 10.1634/ theoncologist.2008-0131
Robert C, Soria JC, Spatz A, et al. Cutaneous side-effects of kinase inhibitors and blocking antibodies. Lancet Oncol. 2005; 6: 491-500. doi: 10.1016/S1470-2045(05)70243-6
Lipworth AD, Robert C, Zhu AX. Hand-foot syndrome (hand-foot skin reaction, palmar-plantar erythrodysesthesia): focus on sorafenib and sunitinib. Oncology. 2009; 77: 257-271. doi: 10.1159/000258880
Yang CH, LinWC, Chuang CK, et al. Hand-foot skin reaction in patients treated with sorafenib: a clinicopathological study of cutaneous manifestations due to multitargeted kinase inhibitor therapy. Br J Dermatol. 2008; 158: 592-596. doi: 10.1111/j.1365- 2133.2007.08357.x Cancer Stud Mol Med Open J
Pragasam V, Verma R, Vasudevan B. Sorafenib and sunitinib: A dermatologist’s perspective. Ind Dermatol Online J. 2014; 5: 1-3. doi: 10.4103/2229-5178.126017
Pascaline BR, Céline N, Golmard JL, Audrey TS, Olivier M, Fabrice T. Early Sorafenib-induced toxicity is associated with drug exposure and UGTIA9 genetic polymorphism in patients with solid tumors: A Preliminary Study. PLoS ONE. 2012; 7(8): e42875. doi: 10.1371/journal.pone.0042875
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