Retrospective Investigation on Cetuximab-induced Hypomagnesemia; Incidence, Time of Onset, and Management

Nakamoto, Eri; Kawakami, Kazuyoshi; Shikibu, Sari; Sugita, Kazuo; Shinozaki, Eiji; Suenaga, Mitsukuni; Matsusaka, Satoshi; Mizunuma, Nobuyuki; Hama, Toshihiro

doi:10.5649/jjphcs.37.403

Cited by 3 publications

(1 citation statement)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nakamoto et al reported that since recovery from severe hypomagnesemia is poor even if supplemental Mg2+ is administered, withdrawal of anti-EGFR antibodies was situationally required. To prevent severe hypomagnesemia, prompt initiation of supportive care should also be required [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Correlation between blood magnesium and calcium concentration in patients treated with an anti-EGFR antibody

Tsujii

Ogaki

Nakae

et al. 2016

J Pharm Health Care Sci

View full text Add to dashboard Cite

BackgroundHypomagnesemia is one of the characteristic side effects of the human anti-epidermal growth factor receptor (EGFR) monoclonal antibodies, cetuximab and panitumumab.The major mechanism of anti-EGFR antibody-related hypomagnesemia is suppression of EGFR-mediated urinary Mg2+ reabsorption in both the renal tubule the intestinal tract.Since Mg2+ is known to affect blood Ca2+ levels through regulation of parathyroid hormone (PTH) secretion, we investigated the correlation between Ca2+ and Mg2+ concentration in blood.MethodsBetween April 2012 and October 2015, blood Mg2+ and Ca2+ concentrations (albumin corrected value) of 22 colon cancer patients undergoing treatment with either cetuximab or panitumumab at Toyooka Public Hospital were measured simultaneously.ResultsHypomagnesemia (of all Grades) was reported in 13 of 22 patients. Two patients had hypomagnesemia of severity > Grade 3.Changes in blood Mg2+ and Ca2+ concentration showed a significant correlation (r2 = 0.7455), which could be expressed using the following equation, Ca2+ concentration = 1.4268 × (Mg2+ concentration) + 7.1126.ConclusionSince the early stages of hypomagnesemia produce no characteristic clinical symptoms, it is easily overlooked until it becomes severe.The investigation results suggest that if low blood Ca2+ concentration (mg/dL) is observed in patients administered anti-EGFR antibodies, early evaluation of blood Mg2+ concentration (mg/dL) and prompt supportive care are required to prevent aggravation of hypomagnesemia.

show abstract

Section: Discussionmentioning

confidence: 99%

Correlation between blood magnesium and calcium concentration in patients treated with an anti-EGFR antibody

Tsujii

Ogaki

Nakae

et al. 2016

J Pharm Health Care Sci

View full text Add to dashboard Cite

show abstract

Identifying optimal magnesium replenishment points based on risk of severe hypomagnesemia in colorectal cancer patients treated with cetuximab or panitumumab

Kimura

Usami

Teramachi

et al. 2020

Cancer Chemother Pharmacol

View full text Add to dashboard Cite

Analysis of Factors Influencing the Development of Hypomagnesemia in Patients Receiving Cetuximab Therapy for Head and Neck Cancer

et al. 2015

View full text Add to dashboard Cite

Cetuximab was approved in Japan as the only clinically available molecular targeted drug for the treatment of head and neck cancer. Hypomagnesemia associated with cetuximab is considered one of the most serious adverse events. However, the factors in‰uencing the development of hypomagnesemia are not clear, although the drug was previously approved for the treatment of patients with colorectal cancer. Thus, we studied the factors involved in the development of hypomagnesemia in patients receiving cetuximab therapy for head and neck cancer. Patients' background data and laboratory values before starting cetuximab therapy did not aŠect the development of hypomagnesemia. Among patients who had never been treated with cisplatin (NT group), 36.4％ developed hypomagnesemia. In contrast, all patients who had previously been treated with cisplatin (T group) developed hypomagnesemia ( p＝0.034). Magnesium is reabsorbed by transient receptor potential subfamily melastatin 6 (TRPM6) in the distal convoluted tubule. The expression level of TRPM6 is controlled by the epidermal growth factor (EGF) pathway. Cetuximab is an EGF receptor inhibitor and reduces the expression of TRPM6. Additionally, recent studies have shown that the expression of TRPM6 is reduced by cisplatin. Therefore, we considered that the serum magnesium level was cumulatively reduced by cetuximab and cisplatin. In conclusion, the T group was more likely to develop hypomagnesemia than the NT group, and therefore the serum magnesium level in the T group requires careful monitoring so that magnesium supplementation can be provided to patients when the level decreases.

show abstract

Retrospective Investigation on Cetuximab-induced Hypomagnesemia; Incidence, Time of Onset, and Management

Cited by 3 publications

References 10 publications

Correlation between blood magnesium and calcium concentration in patients treated with an anti-EGFR antibody

Correlation between blood magnesium and calcium concentration in patients treated with an anti-EGFR antibody

Identifying optimal magnesium replenishment points based on risk of severe hypomagnesemia in colorectal cancer patients treated with cetuximab or panitumumab

Analysis of Factors Influencing the Development of Hypomagnesemia in Patients Receiving Cetuximab Therapy for Head and Neck Cancer

Contact Info

Product

Resources

About