Right Decisions
Acute Oncology Guidelines
Back
Vascular endothelial growth factor inhibiting drug specific toxicities
Reversible posterior leukoencephalopathy syndrome (RPLS)

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Reversible posterior leukoencephalopathy syndrome (RPLS)

Acute Oncology Guidelines

This is a neurological syndrome which can occur rarely in patients treated with all VEGF inhibitors. The symptoms/signs are seizures, headaches, altered mental status, visual disturbance or cortical blindness. It often (but not always) occurs in the setting of accelerated hypertension. Diagnosis is confirmed by urgent brain MRI which demonstrates typical appearances. This is an emergency requiring urgent discussion with the medical on call team and permanent discontinuation of VEGF-i.

Managing RPLS with VEGF-i therapy

Perform a brain MRI to confirm
Treat hypertension
Discontinue VEGF-i permanently
Discuss with medical on call team if assistance with managing BP is required.

Last reviewed: 05/01/2024

Next review date: 05/01/2027

Author(s): Edinburgh Cancer Centre.

Version: 1.1

Approved By: Authorised by CTAC. Refer to Q-Pulse for approval details.

Reviewer name(s): Stewart J.