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Opportunistic and Serious Infections in Patients with Neuroendocrine Tumors Treated with Everolimus: A Multicenter Study of Real-World Patients.
Mauro, Carine; de Jesus, Victor Hugo Fonseca; Barros, Milton; Costa, Frederico Perego; Weschenfelder, Rui F; D'Agustini, Nathalia; Angel, Martin; Luca, Romina; Nuñez, Jose Eduardo; O'Connor, Juan Manuel; Riechelmann, Rachel P.
Afiliação
  • Mauro C; Department of Clinical Oncology, AC Camargo Cancer Center, São Paulo, Brazil.
  • de Jesus VHF; Department of Clinical Oncology, AC Camargo Cancer Center, São Paulo, Brazil.
  • Barros M; Department of Clinical Oncology, AC Camargo Cancer Center, São Paulo, Brazil.
  • Costa FP; Centro de Oncologia, Hospital Sirio Libanes, São Paulo, Brazil.
  • Weschenfelder RF; Department of Oncology, Hospital Moinhos de Vento, Rio Grande do Sul, Brazil.
  • D'Agustini N; Department of Oncology, Hospital Moinhos de Vento, Rio Grande do Sul, Brazil.
  • Angel M; Department of Oncology, Institute Alexander Fleming, Buenos Aires, Argentina.
  • Luca R; Department of Oncology, Institute Alexander Fleming, Buenos Aires, Argentina.
  • Nuñez JE; Department of Clinical Oncology, Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil.
  • O'Connor JM; Department of Clinical Oncology, Hospital de Gastroenterología Bonorino Udaondo, Buenos Aires, Argentina.
  • Riechelmann RP; Department of Clinical Oncology, AC Camargo Cancer Center, São Paulo, Brazil, rachel.riechelmann@accamargo.org.br.
Neuroendocrinology ; 111(7): 631-638, 2021.
Article em En | MEDLINE | ID: mdl-32403102
INTRODUCTION: The incidence of infections is poorly studied in patients with neuroendocrine tumors (NET) treated with everolimus outside of clinical trials. We aimed to evaluate the frequency of and risk factors for opportunistic infections (Opl) or any serious infection in eligible patients. METHODS: This was a retrospective multicenter study of a Latin American cohort of consecutive patients with advanced NET treated with everolimus. Duration of everolimus, comorbidities, Charlson comorbidity score, type of prior treatment, institution, and concurrent immunosuppressive conditions were tested for possible associations with serious (grade 3-5) infections in univariate and multivariable logistic regression models. RESULTS: One hundred eleven patients from 5 centers were included. The median duration of everolimus was 8.9 months. After a median follow-up of 32.9 months, 34 patients (30.6%; 95% CI 22.2-40.1) experienced infections of any grade, with 24 (21.6%; 95% CI 14.8-30.4) having a serious infection and 7 (6.3%; 95% CI 2.6-12.6) having at least 1 OpI (Candida sp., Toxoplasma gondi, Pneumocystis sp., Herpes sp., and Cryptococcus sp.). Four patients (3.6%) died from infections, but only 2 deaths (1.8%) were deemed to be related to everolimus. The multivariable analysis identified everolimus duration (every 6-month increase; OR = 1.28; 95% CI 1.02-1.60; p = 0.03) as an independent risk factor for serious infection. CONCLUSION: Infections are more frequent in NET patients using everolimus than previously reported in clinical trials. Patients on everolimus should be closely monitored for infections, especially those receiving it for several months.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Oportunistas / Tumores Neuroendócrinos / Everolimo / Imunossupressores Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Neuroendocrinology Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Oportunistas / Tumores Neuroendócrinos / Everolimo / Imunossupressores Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Neuroendocrinology Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça