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Severe, symptomatic, dose‐limiting hypophosphatemia induced by hepatic arterial infusion of recombinant tumor necrosis factor in patients with liver metastases
Author(s) -
Giglio Auro Del,
Mavligit Giora M.,
Zukiwski Alexander A.,
Ali Mohamed K.
Publication year - 1991
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19910515)67:10<2459::aid-cncr2820671011>3.0.co;2-l
Subject(s) - hypophosphatemia , medicine , endocrinology , necrosis , tumor necrosis factor alpha , gastroenterology
Twenty‐two patients with liver metastases received 45 courses of recombinant tumor necrosis factor (rTNF) by hepatic arterial infusion in doses ranging from 12.5 to 175 μg/m 2 /d for 5 days by continuous infusion. The induction of statistically significant, dose‐related, severe, albeit transient, hypophosphatemia (< 1.0 mg/dl) associated with clinically significant, right‐sided myocardial dysfunction and severe lassitude was observed. These side effects were promptly reversed after rTNF was stopped and intravenous phosphate supplementation was started. As no significant or consistent increase in urinary phosphate excretion was detected, the rTNF‐induced hypophosphatemia probably resulted from an intracellular shift of phosphate. Since tumor regression was clearly associated with the lowest levels of serum phosphate, hypophosphatemia may be important in the antitumor effects of rTNF.