Everolimus-associated acute kidney injury in patients with metastatic breast cancer

Everolimus, an inhibitor of the rapamycin pathway, is administered with the combination of an aromatase inhibitor for the treatment of metastatic estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancers. Interstitial lung disease is a well-known major adverse event associated with everolimus treatment, but it is often difficult to distinguish between interstitial lung disease and Pneumocystis pneumonia, a lung infection. Acute kidney injury is another adverse event that is associated with everolimus use. In this article, we report a case of Pneumocystis pneumonia without respiratory symptoms and acute kidney injury induced by everolimus treatment in a patient with ER-positive and HER2-negative metastatic breast cancer.

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Successful Remission of Hemolytic-Uremic Syndrome during the Third-line Weekly Gemcitabine for Metastatic Breast Cancer

Breast Cancer Basic and Clinical Research ◽

10.4137/bcbcr.s14920 ◽

2014 ◽

Vol 8 ◽

pp. BCBCR.S14920

Author(s):

Victor C. Kok ◽

Sheng-Chung Wu ◽

Chien-Kuang Lee

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Hemolytic Uremic Syndrome ◽

Cancer Progression ◽

Palliative Chemotherapy ◽

Metastatic Breast ◽

Kidney Injury ◽

Peripheral Blood Smear ◽

Uremic Syndrome ◽

Third Line

Sequential palliative chemotherapy for metastatic breast cancer incorporating weekly gemcitabine administered as three-weeks-on, one-week-off schedule is widely adopted throughout the East Asia region. Hemolytic-uremic syndrome (HUS) associated with weekly gemcitabine for a breast cancer patient is extremely rare. We report here a case of 43-year-old woman with metastatic breast cancer who received weekly gemcitabine as a third-line palliative chemotherapy for her disease. She developed HUS after a cumulative dose of 11,000 mg/m2 gemcitabine, evidenced by microangiopathic hemolytic anemia (MAHA) with schistocytes seen in peripheral blood smear, decreased haptoglobin level (<0.29 mmol/L), thrombocytopenia, negative direct Coombs test, and acute kidney injury. Owing to the ease of administration of weekly gemcitabine, gemcitabine-induced thrombocytopenia, multifactorial anemia in metastatic breast cancer, and possibility of cancer progression, HUS could have gone unnoticed. Breast cancer oncologist should be cognizant of this rare HUS even during weekly gemcitabine treatment.

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Renal toxicity with liposomal doxorubicin in metastatic breast cancer

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155218798157 ◽

2018 ◽

Vol 25 (7) ◽

pp. 1738-1742 ◽

Cited By ~ 1

Author(s):

Kristyn E Yemm ◽

Laura M Alwan ◽

A Bilal Malik ◽

Lupe G Salazar

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Liposomal Doxorubicin ◽

Renal Toxicity ◽

Metastatic Breast ◽

Kidney Injury ◽

Infusion Reactions ◽

Cancer Setting ◽

Cessation Of Treatment

There is no preferred treatment option for metastatic breast cancer; therefore, treatment should provide palliation, prolong survival, control symptoms, and improve quality of life. Liposomal doxorubicin formulations have been shown to have less alopecia, nausea, vomiting, and myelosuppression than traditional doxorubicin, but more skin toxicities and infusion reactions. Prolonged use of liposomal doxorubicin may be associated with unrecognized or less well-defined toxicities. We report a case of acute kidney injury and progressively worsening chronic kidney disease necessitating dialysis in a patient who received prolonged therapy with liposomal doxorubicin for treatment of metastatic breast cancer. This case report should give caution to providers considering prolonged use of liposomal doxorubicin in the metastatic breast cancer setting as we observed sustained renal toxicity, long past the cessation of treatment.

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Pelvic Lymphanedectomy due to metastatic breast cancer causing postrenal acute kidney injury

Mastology ◽

10.29289/259453942020v30s1104 ◽

2020 ◽

Vol 30 (Suppl 1) ◽

Author(s):

Ana Beatriz Charantola Beloni ◽

Ana Clara Charantola Beloni ◽

Leandro Beloni ◽

Lúcio Fábio Caldas Ferraz

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Kidney Function ◽

Metastatic Breast ◽

Kidney Injury ◽

White Female ◽

Luminal B ◽

Invasive Ductal Breast Cancer ◽

Ureter Obstruction ◽

The Right

Introduction: About 30% of the patients healed from breast cancer recurred with metastasis, and the lymphatic is the main path of dissemination. Usually, postrenal acute kidney failure (AKI) is a result of gynecological, urological, gastrointestinal and retroperitoneal cancer, but unusual in breast cancer. Objectives: To report the unusual metastatic behavior of the carcinoma for diagnostic elucidation. Method: Anamnesis and review of medical charts and bibliography. Results: White, female, 69-year old women being retreated for invasive ductal breast cancer, luminal B type, was hospitalized in June, 2018, with hypothesis of bronchopneumonia and AKI due to dehydration and infection. Laboratory examinations indicated urea at 75 mg/dl, creatinine at 2.56 mg/dl, sodium at 141 mmol/L, and potassium at 4.2 mmol/L. The initial conduct included antibiotics and hydration with 0.9% saline solution. Abdominal and bladder ultrasound indicated dilatation of the pelvicalyceal systems system and proximal ureters, without pointing a location and cause of obstruction; urinary bladder with conserved shape and capacity; absence of images compatible with calculi and expansive solid, cystic or complex injuries. Due to the worsened glomerular filtration rate and oliguria, a double J catheter was inserted to the left. However, there was no improvement in kidney function. Then, a nephrostomy was performed to the right, which restituted urine traffic. In February, 2019, urotomography showed dilatation of the pelvicalyceal system and right ureters to the pelvis (L5), where it became narrow, with a 1.5 cm caliber ureter obstruction; multiple metastasis in the pelvic bones and bilateral pleural effusion. A double J catheter was inserted in the right ureter through a cateter via anterograde pathway, thus recovering kidney function and comfort. After 5 months, computed tomography showed pelvic lymphadenopathy as the cause of obstruction. Currently, the patient has a metallic catheter in the right side, with good general status and on anastrozole. Conclusions: Metastatic breast cancer is still challenging and prone to complications. Therefore, its knowledge allows a better approach of patients by correlating them with more diagnostic and care possibilities.

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Pamidronate-Induced Kidney Injury in a Patient With Metastatic Breast Cancer

The American Journal of the Medical Sciences ◽

10.1097/maj.0b013e318184e741 ◽

2009 ◽

Vol 338 (3) ◽

pp. 225-228 ◽

Cited By ~ 4

Author(s):

Masahiko Nagahama ◽

Domenic A. Sica ◽

Domenic A. Sica

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Metastatic Breast ◽

Kidney Injury

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Ribociclib induced acute kidney injury: A case report

Journal of Oncology Pharmacy Practice ◽

10.1177/10781552211007202 ◽

2021 ◽

pp. 107815522110072

Author(s):

Ilkay Gulturk ◽

Mesut Yilmaz ◽

Aykut Ozmen ◽

Seher Yıldız Tacar ◽

Gülçin Sahingoz Erdal ◽

...

Keyword(s):

Breast Cancer ◽

Acute Kidney Injury ◽

Case Report ◽

Dose Reduction ◽

Metastatic Breast ◽

Kidney Injury ◽

Treatment Discontinuation ◽

Close Monitoring ◽

First Case ◽

Grade 3

Introduction Among females, breast cancer is the most common type of cancer. Hormon receptor positive (HR+) subtype constitutes 75% of the diagnosed breast cancers. Combination of the cyclin D-cyclin-dependent kinase 4/6 (CDK4/6) inhibitor and endocrine therapy significantly improves overall survival and progression-free survival. Ribociclib is an oral CDK 4/6 inhibitor and some adverse effects are identified. According to MONALEESA 2-3-7 studies, no adverse effect (AE) were reported due to grade 3 or 4 acute kidney injury (AKI) that caused treatment discontinuation. Case report We report a ribociclib-induced grade 3 AKI in an elderly woman who was treated for metastatic breast cancer. During first cycle of therapy, she was admitted to the oncology clinic with diagnosis of AKI. Management and outcome: Ribociclib treatment was discontinued and secondary causes of AKI were excluded. During the follow-up, kidney function values returned to the normal range spontaneously. Ribociclib treatment was re-initiated by reducing the dose (400 mg daily). Despite dose reduction; grade 3 AKI recurred when ribociclib was re-initiated and the drug was permanently discontinued. Discussion According to MONALEESA 2-3-7 studies; no AE were reported due to grade 3 or 4 AKI. Despite these studies, the FDA reported that 20% of patients with ribociclib + letrozole combination therapy may have any stage elevation of creatinine. Ribociclib induced creatinine elevations are generally mild (grade 1–2) and can be managed by dose reduction or close monitoring of creatinine levels. We report the first case of grade 3 AKI that caused treatment discontinuation following administration of ribociclib.

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