Nintedanib-Induced Delayed Mucosal Healing after Adjuvant Radiation in a Case of Oropharyngeal Carcinoma

• Published in: Case reports in oncology Vol. 15; no. 2; pp. 776 - 782
• Main Authors: Takahashi, Satoru, Endo, Masashi, Fukuda, Yukiko, Ogawa, Kazunari, Nakamura, Michiko, Okada, Kohei, Kawahara, Masahiro, Akahane, Keiko, Nagatomo, Takafumi, Onaga, Ryutaro, Nishino, Hiroshi, Mori, Harushi, Shirai, Katsuyuki
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 30.08.2022; Karger Publishers
• Subjects: adverse event; Analgesics; Angiogenesis; Cancer therapies; Case Report; Case reports; Cell growth; Cytotoxicity; Disease; Drug dosages; Drug withdrawal; Endoscopy; Inhibitor drugs; Lymphatic system; Monoclonal antibodies; Mucositis; multikinase inhibitor; nintedanib; Pulmonary fibrosis; Radiation; Radiation therapy; radiotherapy; Targeted cancer therapy; Throat cancer; Tumors; tyrosine kinase inhibitor; Vascular endothelial growth factor; Wound healing; Nintedanib; Adverse event; Multikinase inhibitor; Radiotherapy; Tyrosine kinase inhibitor
• ISSN: 1662-6575; 1662-6575
• DOI: 10.1159/000526077

Abstract Since the launch of imatinib in 2001, tyrosine kinase inhibitors are being used in chemotherapy for a wide range of malignant tumors. Drugs that inactivate multiple molecular mechanisms are called multikinase inhibitors (MKIs). Nintedanib is a type of MKI that inhibits downstream cascades in three systems: vascular endothelial growth factor receptor, fibroblast growth factor receptor, and platelet-derived growth factor receptor inhibitions. It was initially developed as an anticancer drug for non-small-cell lung carcinoma; however, it was also found to inhibit the proliferation of fibroblasts associated with chronic inflammation in the lungs. Therefore, it is being more widely used to treat idiopathic pulmonary fibrosis, a benign disease, than as an antineoplastic agent. Several studies have reported adverse events associated with the concurrent use of MKIs with surgery or radiotherapy. Specifically, there has been a report cautioning against delayed wound healing associated with the use of nintedanib in patients undergoing surgery. However, there is no specific mention of its concurrent use during irradiation. We describe a case of a 72-year-old man with severely delayed recovery from radiation mucositis when nintedanib was being administered for benign disease.