Management of metabolic adverse effects of everolimus in patients with renal carcinoma

Czech version

Authors: Jana Gregorová ^1,2; Petra Holečková ³; Kateřina Žáková ¹
Authors‘ workplace: Oddělení klinické farmacie, Nemocnice Na Bulovce, Praha ¹; Ústav aplikované farmacie, Farmaceutická fakulta VFU, Brno ²; Ústav radiační onkologie 1. LF UK a Nemocnice Na Bulovce, Praha ³
Published in: Čas. Lék. čes. 2019; 158: 300-305
Category: Original Article

Overview

Everolimus is administered to patients with metastatic renal cell carcinoma in full daily dose of 10 mg or in reduced daily dose of 5 mg in case adverse effect occurred. These include metabolic adverse effects, mucositis, anorexia, and non-infectious pneumonitis and lead to increase in morbidity and decrease in the quality of life of the patient. Our goal was to evaluate the administration of fenofibrate and metformin in everolimus induced hypertriglyceridemia and hyperglycemia.

The role of mTOR in lipid and glucose metabolism was researched in literature. The effect of including fenofibrate and metformin into metabolic adverse effect management guidelines in metastatic renal cell carcinoma patients who are administered everolimus was evaluated.

Fenofibrate, metformin, and everolimus have several similar effects on intracellular level, therefore the effect of fenofibrate and metformin in treating everolimus induced metabolic adverse effects in metastatic renal cell carcinoma patients may be limited. The manifestation of metabolic adverse effects in patients treated with everolimus is not identical with metabolic syndrome or type II diabetes in standard population.

Keywords:

fenofibrate – everolimus – metabolic adverse effects – metformin – Renal cell carcinoma

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