Uncommon gastrointestinal bleeding during targeted therapy for advanced renal cell carcinoma: A report of four cases

Fujihara,Shintaro; Mori,Hirohito; Kobara,Hideki; Nishiyama,Noriko; Ayaki,Maki; Ohata,Ryo; Ueda,Nobufumi; Sugimoto,Mikio; Kakehi,Yoshiyuki; Masaki,Tsutomu

doi:10.3892/ol.2015.3671

Uncommon gastrointestinal bleeding during targeted therapy for advanced renal cell carcinoma: A report of four cases

Authors:
- Shintaro Fujihara
- Hirohito Mori
- Hideki Kobara
- Noriko Nishiyama
- Maki Ayaki
- Ryo Ohata
- Nobufumi Ueda
- Mikio Sugimoto
- Yoshiyuki Kakehi
- Tsutomu Masaki
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Affiliations: Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, Kagawa 761‑0793, Japan, Department of Urology, Tottori Red Cross Hospital, Tottori 680‑8517, Japan, Department of Urology, Faculty of Medicine, Kagawa University, Kagawa 761‑0793, Japan
Published online on: September 3, 2015 https://doi.org/10.3892/ol.2015.3671
Pages: 2895-2898

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Abstract

Clinically available targeted agents to treat advanced renal cell carcinoma (RCC) include sunitinib, sorafenib and temsirolimus. Sorafenib and sunitinib have been associated with bleeding in selected trials, but clinical and endoscopic characteristics of gastrointestinal bleeding are not well described. Herein, we report four cases of advanced RCC in which endoscopic hemostasis effectively resolved high‑grade, life‑threatening gastrointestinal bleeding that occurred during targeted therapy. Although stomatitis and mucositis have occurred during targeted therapies, life‑threatening gastrointestinal bleeding is less common. In these four patients, the origins of gastrointestinal bleeding were identified, and complete endoscopic hemostasis was achieved. Endoscopies revealed variable characteristics including angiodysplasia, multiple gastric ulcers and oozing bleeding of the normal mucosa. Although the most effective diagnostic and treatment strategies are disputed, endoscopic examinations are best performed before starting targeted therapies. Additionally, these patients should be monitored even for rare life‑threatening events.

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