Opinion|Videos|March 18, 2025
Navigating TKI Toxicities: Expert Perspectives and Clinical Distinctions
Author(s)Pedro Barata, MD, MSc, FACP
An expert discusses how medical professionals counsel patients on adverse event (AE) risks with tyrosine kinase inhibitors (TKIs) such as lenvatinib/everolimus by highlighting key safety distinctions, including hypertension (HTN), fatigue, and diarrhea. For third-line tivozanib, tolerability and common toxicities (eg, Palmar-Plantar Erythrodysesthesia (PPE), HTN) are considered. AE incidence, discontinuation rates, and drug interactions guide treatment choices. Managing toxicities involves prevention, monitoring, and mitigation strategies, with dose modifications tailored based on severity and combination regimens. Community oncologists are advised on proactive AE management to optimize outcomes.
Episodes in this series
Video content above is prompted by the following:
- How do you counsel patients regarding the risk of AEs with single-agent TKIs? And with lenvatinib/everolimus? What do you view as clinically relevant distinctions in their safety profiles?
- Please share your perspectives on the tolerability of tivozanib vs other options you would strongly consider as third-line therapy for a patient like this.
- Most common toxicities
- Incidence of grade 3 or greater AEs, discontinuations
- Drug-drug interactions
- What toxicities are most concerning to you? Which do you find most challenging to manage (eg, HTN, fatigue, PPE/hand-foot skin reaction (HFSR) diarrhea)?
- What advice can you offer to community oncologists with respect to management of TKI-associated AEs?
- How do you prevent, monitor, mitigate, and manage TKI-associated toxicities?
- How do you decide which drug to modify when using a combination regimen?
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