Case report: Enfortumab vedotin induced refractory DKA and multi organ failure – a rare fatal adverse event
There are very few therapeutic options to treat patients with locally advanced or metastatic Urothelial Cancer (UC). Enfortumab vedotin (EV) was recently approved by the FDA and has become a new therapeutic option for patients previously managed with conventional treatments. Despite its efficacy, EV...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1332478/full |
| _version_ | 1797307031783211008 |
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| author | Astha Koolwal Kapoor Carleton S. Ellis Carleton S. Ellis Deepali Pandey Derek B. Allison Derek B. Allison Derek B. Allison Zin W. Myint Zin W. Myint |
| author_facet | Astha Koolwal Kapoor Carleton S. Ellis Carleton S. Ellis Deepali Pandey Derek B. Allison Derek B. Allison Derek B. Allison Zin W. Myint Zin W. Myint |
| author_sort | Astha Koolwal Kapoor |
| collection | DOAJ |
| description | There are very few therapeutic options to treat patients with locally advanced or metastatic Urothelial Cancer (UC). Enfortumab vedotin (EV) was recently approved by the FDA and has become a new therapeutic option for patients previously managed with conventional treatments. Despite its efficacy, EV carries the potential for infrequent yet severe adverse effects. In this report, we present a case of a patient undergoing EV treatment for urothelial carcinoma who developed refractory diabetic ketoacidosis (DKA) unresponsive to escalating insulin doses and necessitating continuous renal replacement therapy. While DKA was resolved, the patient eventually succumbed to progressive maculopapular skin rash, liver failure, and respiratory failure. Additionally, the study delves into a review of cases of EV-induced refractory DKA in the literature, shedding light on the similarities in patient profiles, timelines of adverse effects and the treatment strategies employed to manage the ensuing complications. |
| first_indexed | 2024-03-08T00:50:29Z |
| format | Article |
| id | doaj.art-e78c1ead756244ecbf7f8bc745251f2a |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-08T00:50:29Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-e78c1ead756244ecbf7f8bc745251f2a2024-02-15T05:11:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-02-011410.3389/fonc.2024.13324781332478Case report: Enfortumab vedotin induced refractory DKA and multi organ failure – a rare fatal adverse eventAstha Koolwal Kapoor0Carleton S. Ellis1Carleton S. Ellis2Deepali Pandey3Derek B. Allison4Derek B. Allison5Derek B. Allison6Zin W. Myint7Zin W. Myint8Department of Internal Medicine, Vassar Brothers Medical Center Nuvance Health, Poughkeepsie, NY, United StatesMarkey Cancer Center, University of Kentucky, Lexington, KY, United StatesDepartment of Pharmacy, University of Kentucky, Lexington, KY, United StatesMarkey Cancer Center, University of Kentucky, Lexington, KY, United StatesMarkey Cancer Center, University of Kentucky, Lexington, KY, United StatesDepartment of Urology, University of Kentucky, Lexington, KY, United StatesDepartment of Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY, United StatesMarkey Cancer Center, University of Kentucky, Lexington, KY, United StatesDepartment of Internal Medicine, Division of Medical Oncology, University of Kentucky, Lexington, KY, United StatesThere are very few therapeutic options to treat patients with locally advanced or metastatic Urothelial Cancer (UC). Enfortumab vedotin (EV) was recently approved by the FDA and has become a new therapeutic option for patients previously managed with conventional treatments. Despite its efficacy, EV carries the potential for infrequent yet severe adverse effects. In this report, we present a case of a patient undergoing EV treatment for urothelial carcinoma who developed refractory diabetic ketoacidosis (DKA) unresponsive to escalating insulin doses and necessitating continuous renal replacement therapy. While DKA was resolved, the patient eventually succumbed to progressive maculopapular skin rash, liver failure, and respiratory failure. Additionally, the study delves into a review of cases of EV-induced refractory DKA in the literature, shedding light on the similarities in patient profiles, timelines of adverse effects and the treatment strategies employed to manage the ensuing complications.https://www.frontiersin.org/articles/10.3389/fonc.2024.1332478/fulldiabetes ketoacidosisCRRTinsulinenfortumab vedotinmaculopapular rashliver failure |
| spellingShingle | Astha Koolwal Kapoor Carleton S. Ellis Carleton S. Ellis Deepali Pandey Derek B. Allison Derek B. Allison Derek B. Allison Zin W. Myint Zin W. Myint Case report: Enfortumab vedotin induced refractory DKA and multi organ failure – a rare fatal adverse event Frontiers in Oncology diabetes ketoacidosis CRRT insulin enfortumab vedotin maculopapular rash liver failure |
| title | Case report: Enfortumab vedotin induced refractory DKA and multi organ failure – a rare fatal adverse event |
| title_full | Case report: Enfortumab vedotin induced refractory DKA and multi organ failure – a rare fatal adverse event |
| title_fullStr | Case report: Enfortumab vedotin induced refractory DKA and multi organ failure – a rare fatal adverse event |
| title_full_unstemmed | Case report: Enfortumab vedotin induced refractory DKA and multi organ failure – a rare fatal adverse event |
| title_short | Case report: Enfortumab vedotin induced refractory DKA and multi organ failure – a rare fatal adverse event |
| title_sort | case report enfortumab vedotin induced refractory dka and multi organ failure a rare fatal adverse event |
| topic | diabetes ketoacidosis CRRT insulin enfortumab vedotin maculopapular rash liver failure |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1332478/full |
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