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Pneumothorax as adverse event in patients with lung metastases of soft tissue sarcoma treated with pazopanib: a single reference centre case series.
[liposarcoma]
Recently
,
the
phase
III
PALETTE
study
introduced
pazopanib
(
Votrient
®
)
as
treatment
for
adult
patients
with
locally
advanced
or
metastatic
non-
liposarcoma
soft
tissue
sarcoma
after
prior
treatment
with
doxorubicin
and
/
or
ifosfamide
.
Pneumothorax
was
reported
as
adverse
event
in
8
of
246
treated
patients
(
3
.
3
%
)
in
that
study
.
This
case
series
presents
the
incidence
and
clinic
of
this
complication
in
the
Leiden
University
Medical
Centre
.
Forty
-
three
patients
were
treated
with
pazopanib
of
which
six
patients
(
14
.
0
%
)
developed
a
pneumothorax
.
These
six
patients
were
treated
for
malignant
peripheral
nerve
sheath
tumour
,
angiosarcoma
,
synovial
sarcoma
,
fibromyxomatoid
sarcoma
,
pleomorphic
sarcoma
and
endometrial
stromal
sarcoma
.
All
six
patients
had
subpleural
pulmonary
or
pleural
metastases
at
the
start
of
pazopanib
and
the
pneumothorax
developed
during
or
shortly
after
treatment
with
pazopanib
and
was
difficult
to
treat
.
The
incidence
reported
by
us
is
higher
than
the
incidence
in
the
PALETTE
study
.
Trials
with
pazopanib
in
renal
cell
carcinoma
,
urothelial
carcinoma
and
cervix
carcinoma
did
not
report
pneumothorax
as
an
adverse
event
,
suggesting
pneumothorax
as
a
specific
adverse
event
in
soft
tissue
sarcoma
patients
treated
with
pazopanib
.
This
may
be
related
to
the
fact
that
there
is
often
pleural
metastatic
involvement
and
cystic
degeneration
due
to
pazopanib
treatment
may
add
to
the
risk
.
The
risk
of
an
,
often
difficult
to
treat
,
pneumothorax
during
pazopanib
therapy
should
be
discussed
with
the
patient
before
initiation
of
treatment
for
a
pulmonary
metastasized
sarcoma
and
physicians
should
be
alert
to
the
occurrence
of
such
an
event
.