Medical Oncology

, Volume 29, Issue 4, pp 3003–3008

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

  • Antoine Adenis
  • Olivier Bouché
  • François Bertucci
  • Elsa Kalbacher
  • Charles Fournier
  • Philippe Cassier
  • Olivier Collard
  • Jacques-Olivier Bay
  • Antoine Italiano
  • Christine Chevreau
  • Stéphanie Clisant
  • Andrew Kramar
  • Jean-Yves Blay
  • Nicolas Penel
Original Paper

DOI: 10.1007/s12032-012-0204-1

Cite this article as:
Adenis, A., Bouché, O., Bertucci, F. et al. Med Oncol (2012) 29: 3003. doi:10.1007/s12032-012-0204-1

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.

Keywords

Creatine phosphokinase Tyrosine kinase inhibitors Rhabdomyolysis Gastrointestinal stromal tumor 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Antoine Adenis
    • 1
    • 2
  • Olivier Bouché
    • 3
  • François Bertucci
    • 4
  • Elsa Kalbacher
    • 5
  • Charles Fournier
    • 6
  • Philippe Cassier
    • 7
  • Olivier Collard
    • 8
  • Jacques-Olivier Bay
    • 9
  • Antoine Italiano
    • 10
  • Christine Chevreau
    • 11
  • Stéphanie Clisant
    • 12
  • Andrew Kramar
    • 6
  • Jean-Yves Blay
    • 7
  • Nicolas Penel
    • 1
    • 13
  1. 1.Medical Oncology DepartmentCentre Oscar LambretLilleFrance
  2. 2.Catholic UniversityLilleFrance
  3. 3.Gastroenterology DepartmentUniversity Hospital, Hôpital Robert DebréReimsFrance
  4. 4.Medical Oncology DepartmentInstitut Paoli CalmetteMarseilleFrance
  5. 5.Medical Oncology DepartmentUniversity Hospital, Hôpital Jean MinjozBesançonFrance
  6. 6.Methodology and BiostatisticsCentre Oscar LambretLilleFrance
  7. 7.Medical Oncology DepartmentCentre Léon BerardLyonFrance
  8. 8.Medical Oncology DepartmentInstitut de Cancérologie de la LoireSaint Priest en JarezFrance
  9. 9.Medical Oncology DepartmentCentre Jean PerrinClermont-FerrandFrance
  10. 10.Medical Oncology DepartmentInstitut BergoniéBordeauxFrance
  11. 11.Medical Oncology DepartmentInstitut Claudius RegaudToulouseFrance
  12. 12.Clinical Research UnitCentre Oscar LambretLilleFrance
  13. 13.Faculté de MédecineLille-Nord de France University (EA 2694; Epidemiology, Public Health and Quality of Care)LilleFrance

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