Best practices in the management of toxicities related to anti-EGFR agents for metastatic colorectal cancer

Ouwerkerk, Jannemieke; Boers–Doets, Christine B.

doi:10.1016/j.ejon.2010.03.004

Cited by 37 publications

(59 citation statements)

References 54 publications

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“…One aim of our intervention was to strengthen the patients to be able to manage their own treatment of acneiform eruption. This aim succeeded and is in line with Ouwerkerk et al, [14] who claimed that oncology nurses can help patients maintain their quality of life, promoted treatment adherence by empowering patients to be more involved in their treatment and in the management of treatment-related toxicities.…”

Section: Reflectionssupporting

confidence: 61%

“…Therefore it is essential for patients to start tetracycline at home, especially in patients who are being treated with cetuximab every second week. [14] In relation to development of resistance, we might question continuation of prophylactic antibiotic for an indefinite time period. This must be weighed against treatment with cetuximab in the optimal dose intensity to secure optimal efficacy.…”

Section: Strengthmentioning

confidence: 99%

“…The median reported time to rash development was 10 days (95% CI [8][9][10][11][12][13][14]. Six patients (10%) did not develop any rash during the study period.…”

Section: Rashmentioning

confidence: 99%

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Nursing interventions to minimize cetuximab-induced dermatologic toxicity

Larsen

Thode

Dieperink

et al. 2017

CNS

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Objective: This study investigated early nursing interventions with the purpose to minimize cetuximab-induced acneiform eruption. The most important side-effect of cetuximab is dermatologic toxicity, up to 90%. Dose-reduction or interruption of cetuximab reduces severity of dermatologic toxicity, probably at the cost of reduced efficacy of the cancer therapy. Thus, prevention or effective supportive care during treatment is important. The study evaluated if patient education could ensure compliance of cancer treatment and effect of oral tetracycline on acneiform eruption, with the purpose to minimize severity of dermatologic toxicity and reduce the use of tetracycline. Methods: The design was a single group prospective interventional study. Gastro-intestinal (GI) cancer patients treated with cetuximab between April 2009 and June 2011 were educated to start treatment with tetracycline 500 mg twice daily when acneiform eruption occurred. Patient's dermatologic toxicity were graded (by CTCAE) and registered by nurses. Results: Sixty-three patients were evaluable. Patients started tetracycline when acneiform eruption occurred. It reduced severity but not incidence of acneiform eruption, 10% of the patients never developed acneiform eruption and therefore never received tetracycline. Conclusions: Patient-education by a trained oncology nurse in the handling of cetuximab induced acneiform eruption is manageable and effective and ensures a high number of patients carrying through treatment with a full dose of cetuximab.

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Section: Reflectionssupporting

confidence: 61%

Section: Strengthmentioning

confidence: 99%

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Nursing interventions to minimize cetuximab-induced dermatologic toxicity

Larsen

Thode

Dieperink

et al. 2017

CNS

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“…35,36 Treating hypomagnesemia in patients with cancer can be challenging and may occasionally require intravenous administration because large doses of oral magnesium can provoke severe diarrhea. 37 Hypophosphatemia is more common than hyperphosphatemia in patients with cancer, but both can occur in the setting of several cytotoxic drugs. Uptake of phosphorus by rapidly growing tumors can occasionally cause hypophosphatemia, whereas rapid breakdown of tumors with chemotherapy, exemplified by tumor lysis syndrome associated with Burkitt lymphoma treated with rituximab, can lead to severe hyperphosphatemia.…”

Section: Unique Features Of Nephrologic Disorders In Cancermentioning

confidence: 99%

Onconephrology

Salahudeen

Bonventre

2013

Journal of the American Society of Nephrology

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Renal diseases in patients with cancer have many unique features, and often these diseases require specialized approaches. Newer cancer therapy has increased cancer cure rate and survival time, but such benefit is not fully realized, partly because of therapy-associated toxicities. Fluid and electrolyte abnormalities are very common in patients with cancer, as are acute and chronic kidney injury. With the evolving complexities of newer cancer therapies, a comprehensive team approach is becoming necessary. It is essential for nephrologists to be informed and involved in cancer care. Many nephrologists caring for patients with cancer in the United States have recently met and formed a focus group, the OncoNephrology Forum, under the American Society of Nephrology. This update addresses what is clinically unique about onconephrology, the objectives and functions of the newly formed forum, and the potential of onconephrology becoming a subspecialty in nephrology.

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“…Historically, chemotherapy (CTX) was one of the standard treatments for GI cancers (2)(3)(4)(5)(6)(7)(8). These agents are administered to reduce tumor burden, decrease tumor-related symptoms, improve patients' well-being, and prolong survival (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Differences in symptom occurrence, severity, and distress ratings between patients with gastrointestinal cancers who received chemotherapy alone or chemotherapy with targeted therapy

Tantoy

Dhruva

Cataldo

et al. 2017

J. Gastrointest. Oncol.

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Background: Approximately 28% of patients with gastrointestinal (GI) cancers will receive targeted therapy (TT) because of the associated increases in survival. Only four studies have examined the symptom experience of these patients. To date, no studies have evaluated for differences in symptom occurrence, severity, and distress between patients who received chemotherapy (CTX) alone (n=304) or CTX with TT (n=93).Methods: Patients completed self-report questionnaires, approximately one week after they received CTX.A modified version of the Memorial Symptom Assessment Scale (MSAS) was used to obtain data on symptom occurrence, severity, and distress. Binary logistic regression analyses were used to test for differences in symptom occurrence rates between the two treatment groups. Ordinal logistic regression analyses were used to test for differences in severity and distress ratings between the two treatment groups.Results: Patients who received CTX with TT were significantly younger (P=0.009); were diagnosed with cancer longer (P=0.004); had a higher number of prior treatments (P=0.024); had metastatic disease, specifically to the liver (P<0.001); had a diagnosis of anal, colon, rectum, or colorectal cancer (CRC) (P<0.001); and were positive for detection of B-Raf proto-oncogene, serine/threonine kinase (BRAF) and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations (both P<0.001). In addition, CTX treatment regimens were significantly different between the two groups (P<0.001). After controlling for significant covariates, patients who received TT reported lower occurrence rates for lack of energy, cough, feeling drowsy, and difficulty sleeping (all, P<0.05). Patients who received TT reported lower severity scores for dry mouth (P=0.034) and change in the way food tastes (P=0.035). However, they reported higher severity scores for "I don't look like myself" (P=0.026).No differences in symptom distress scores were found between the two treatment groups.Conclusions: This study is the first to evaluate for differences in the symptom experience of GI cancer patients who received CTX alone or CTX with TT using a multidimensional symptom assessment scale.While between group differences in patients' symptom experiences were identified, both treatment groups warrant ongoing assessments to optimally manage their symptoms.

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Best practices in the management of toxicities related to anti-EGFR agents for metastatic colorectal cancer

Cited by 37 publications

References 54 publications

Nursing interventions to minimize cetuximab-induced dermatologic toxicity

Nursing interventions to minimize cetuximab-induced dermatologic toxicity

Onconephrology

Differences in symptom occurrence, severity, and distress ratings between patients with gastrointestinal cancers who received chemotherapy alone or chemotherapy with targeted therapy

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