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Imatinib Oedema — SCE Medical Oncology MCQ

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EasyImmunotherapy & Targeted TherapyImatinib OedemaSCE Medical Oncology

A 60-year-old man on imatinib for GIST develops significant periorbital and lower limb oedema. His cardiac function is normal. Albumin is normal. Renal function is normal. What causes this?

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Correct answer: C — Imatinib-induced fluid retention — a common dose-dependent adverse effect caused by PDGFR inhibition in mesenchymal tissues, NOT cardiac failure; managed with diuretics if symptomatic, dose reduction if severe

Fluid retention (oedema, particularly periorbital) is one of the most common imatinib adverse effects (~60-70%). The mechanism involves PDGFR inhibition in pericytes and mesenchymal cells affecting capillary permeability. Features: periorbital oedema (most characteristic — often the first sign), peripheral oedema, weight gain, rarely pleural effusions or ascites. Management: mild → observation; moderate → diuretics (furosemide); severe → dose reduction. Cardiac function should be assessed to exclude imatinib-related cardiomyopathy (rare). This is distinct from anthracycline cardiotoxicity.

Reference: BNF Imatinib; ESMO 2024 GIST