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Serum creatine kinase increase in patients treated with tyrosine kinase inhibitors for solid tumors

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Abstract

Regarding the frequency of muscular complains with the use of tyrosine kinase inhibitors (TKIs), we hypothesize that creatine kinase (CK) elevation may be more frequent than usually reported. We conducted a prospective study on patients treated with TKIs for solid tumors, to assess the incidence of CK increase on treatment. Most of the patients (105/155) had a gastrointestinal stromal tumor. Treatments were carried out with the following drugs: imatinib (87 cases); sunitinib (21 cases); HER antagonists (14 cases), other TKIs (15 cases); and imatinib-based combinations (2 cases). Myalgias were found in 50/155 patients (32 %). Fifty-four patients (35 %; 95 %CI, 27–42 %) had elevated CK. According to NCI-CTC grading, there was 49/54 (31 %) grade 1 and 5/54 (3 %) grade 2 (2.5 to 5 times ULN). CK elevation was more frequent with imatinib than with other TKIs (39 cases, 45 % vs. 14 cases, 21 %, respectively; chi-squared test: P = 0.003), and CK was more likely to be abnormal in patients treated with any TKI for more than 6 months. We found increased CK in about one-third of patients under TKIs for solid tumors, including 3 % of patients with CK as high as 2.5–5 times ULN.

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Acknowledgments

We would like to thank patients and care providers, as well as colleagues in charge of the administrative and editing work, Ms Stéphanie Vasseur and Séverine Marchant, respectively. We are indebted to Professor Christian Noel (Lille, France) for his helpful comments on renal function.

Conflict of interest

The authors have no conflict of interest to declare.

Author information

Authors and Affiliations

  1. Medical Oncology Department, Centre Oscar Lambret, BP307, 59020, Lille, France

    Antoine Adenis & Nicolas Penel

  2. Catholic University, 60 boulevard Vauban, Lille, France

    Antoine Adenis

  3. Gastroenterology Department, University Hospital, Hôpital Robert Debré, Avenue du Général Koenig, Reims, France

    Olivier Bouché

  4. Medical Oncology Department, Institut Paoli Calmette, 232 Boulevard Ste Marguerite, Marseille, France

    François Bertucci

  5. Medical Oncology Department, University Hospital, Hôpital Jean Minjoz, 3 Boulevard Alexandre Fleming, Besançon, France

    Elsa Kalbacher

  6. Methodology and Biostatistics, Centre Oscar Lambret, 3 rue Combemale, Lille, France

    Charles Fournier & Andrew Kramar

  7. Medical Oncology Department, Centre Léon Berard, 28 rue Laennec, Lyon, France

    Philippe Cassier & Jean-Yves Blay

  8. Medical Oncology Department, Institut de Cancérologie de la Loire, 108 Bis av. Albert Raimond, Saint Priest en Jarez, France

    Olivier Collard

  9. Medical Oncology Department, Centre Jean Perrin, 58 Rue Montalembert, Clermont-Ferrand, France

    Jacques-Olivier Bay

  10. Medical Oncology Department, Institut Bergonié, 229 Cours Argonne, Bordeaux, France

    Antoine Italiano

  11. Medical Oncology Department, Institut Claudius Regaud, 20 Rue Pont St Pierre, Toulouse, France

    Christine Chevreau

  12. Clinical Research Unit, Centre Oscar Lambret, 3 rue Combemale, Lille, France

    Stéphanie Clisant

  13. Faculté de Médecine, Lille-Nord de France University (EA 2694; Epidemiology, Public Health and Quality of Care), Pôle Recherche, 1 place de Verdun, Lille, France

    Nicolas Penel

Authors
  1. Antoine Adenis
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  2. Olivier Bouché
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  3. François Bertucci
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  4. Elsa Kalbacher
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  5. Charles Fournier
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  6. Philippe Cassier
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  7. Olivier Collard
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  8. Jacques-Olivier Bay
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  9. Antoine Italiano
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  10. Christine Chevreau
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  11. Stéphanie Clisant
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  12. Andrew Kramar
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  13. Jean-Yves Blay
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  14. Nicolas Penel
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Corresponding author

Correspondence to Antoine Adenis.

Additional information

This study is conducted on behalf of the French Sarcoma Group (GSF/GETO).

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Adenis, A., Bouché, O., Bertucci, F. et al. Serum creatine kinase increase in patients treated with tyrosine kinase inhibitors for solid tumors. Med Oncol 29, 3003–3008 (2012). https://doi.org/10.1007/s12032-012-0204-1

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  • DOI: https://doi.org/10.1007/s12032-012-0204-1

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