Klin Farmakol Farm. 2018;32(2):33-37 | DOI: 10.36290/far.2018.013

Life threatening hypoglycaemia in a child with infantile myofibromatosis

Lenka Součková^1,2,4, Pavel Mazánek^2,3, Peter Múdry^2,3, Kateřina Nebeská¹, Jaroslav Štěrba^1,2,3,4

¹ Farmakologický ústav, Lékařská fakulta, Masarykova univerzita, Brno

² Klinika dětské onkologie, Fakultní nemocnice Brno

³ Klinika dětské onkologie, Lékařská fakulta, Masarykova univerzita, Brno

⁴ Mezinárodní centrum klinického výzkumu Fakultní nemocnice u sv. Anny, Brno

Sunitinib belongs to a group of anticancer drugs whose mechanism of action is based on the inhibition of a number of receptortyrosine kinases involved in tumor growth, pathological angiogenesis and metastatic cancer progression. In particular, sunitinibinhibits the platelet growth factor receptors (PDGFR-α and PDGFR-β), vascular endothelial growth factor receptors (VEGFR-1,VEGFR-2 and VEGFR-3), stem cell factor receptor (Kit) like tyrosine kinase 3 (Flt3, Fms-like tyrosine kinase-3), a factor stimulatingfactor colony (CSF-1R) receptor, and a glial cell derived neurotrophic factor receptor.Although sunitinib (Sutent®) is registered only for the treatment of adult patients with specific diagnoses (gastrointestinal stromaltumor (GIST) after failure of imatinib treatment due to resistance or intolerance, also advanced/metastatic renal cell carcinoma(mRCC) or pancreatic neuroendocrine tumours (pNET) with disease progression), there is clinical experience with the use of sunitinibin pediatric patients in “off-label” mode, outside the SPC, for the treatment of a different type of cancer wherein cancer cellsshow increased phosphorylation of receptor tyrosine kinases, whose activity is capable to be inhibited by sunitinib.In the article we describe the course of treatment of a pediatric patient with infantile myofibromatosis, after the failure of conventional chemotherapy the genetic and proteomic analysis was performed and on basis of the results sunitinib was administered.During treatment with sunitinib, side effects have been reported which required a dose adjustment. One of the serious side effectswas severe hypoglycaemia, which led to the hospitalization of the patient. This adverse effect of sunitinib is mentioned for thefirst time in czech literature in pediatric patient.

Keywords: hypoglycaemia, infantile myofibromatosis, sunitinib, adverse effect

Published: August 13, 2018  Show citation