Best practices in the management of toxicities related to anti-EGFR agents for metastatic colorectal cancer
Best practices in the management of toxicities related to anti-EGFR agents for metastatic colorectal cancer
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DOI：
10.1016/j.ejon.2010.03.004
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发表时间：
2010-09-01
影响因子：
2.8
通讯作者：
Boers-Doets, Christine
中科院分区：
文献类型：
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作者：
Ouwerkerk, Jan;Boers-Doets, Christine
目的：为肿瘤科护士提供一个概述的毒性管理与抗表皮生长因子受体（EGFR）单克隆抗体西妥昔单抗和帕尼单抗在转移性结直肠癌patients with metastatic colorectal cancer.Methods：单克隆抗体，如西妥昔单抗和帕尼单抗，靶向EGFR的转移性结直肠癌患者提供了有效的治疗选择。这两种抗体都可以作为单一疗法使用;西妥昔单抗也被批准与化疗联合使用。我们回顾了有关的迹象和症状，严重程度的评估，并提供策略，以防止和管理不良事件与这些agents.Key结果：这一类的治疗是与一个整体可接受的不良事件的档案，是明显不同于传统的化疗药物。与引起骨髓抑制、粘膜炎以及恶心和呕吐的细胞毒性化疗相反，抗EGFR治疗报告的常见毒性包括更常见的皮肤毒性、电解质失衡和腹泻，以及较不常见的眼部毒性。输注反应也观察到嵌合体单克隆抗体cetuximab.Conclusions：肿瘤科护士在管理的多药治疗方案，特别是在识别和管理的毒性，病人的教育和病人的支持发挥了关键作用。通过降低与抗EGFR治疗相关的不良事件的发生率和严重程度，肿瘤科护士有可能维持患者坚持完成治疗，早期识别体征和症状，主动管理不良事件，并提供适当的治疗干预，从而改善患者的生活质量。(C)2010爱思唯尔有限公司保留所有权利。
Purpose: To provide oncology nurses with an overview of the toxicity management associated with the anti-epidermal growth factor receptor (EGFR) monoclonal antibodies cetuximab and panitumumab in patients with metastatic colorectal cancer.Methods: Monoclonal antibodies such as cetuximab and panitumumab that target EGFR have provided patients with metastatic colorectal cancer with effective treatment options. Both antibodies can be used as monotherapy; cetuximab is also approved for use in combination with chemotherapy. We reviewed the literature regarding the signs and symptoms, assessment of severity, and strategies available to prevent and manage adverse events associated with these agents.Key results: This class of therapeutics is associated with an overall acceptable adverse event profile that is distinctly different from conventional chemotherapeutics. In contrast to cytotoxic chemotherapy, which causes myelosuppression, mucositis, and nausea and vomiting, common toxicities reported for anti-EGFR therapy include the more frequent cutaneous toxicities, electrolyte imbalances, and diarrhoea, as well as the less frequent ocular toxicities. Infusion reactions are also observed with the chimerical monoclonal antibody cetuximab.Conclusions: Oncology nurses play a key role in the administration of multi-agent treatment regimens, especially with respect to the identification and management of toxicities, patient education, and patient support. By reducing the incidence and severity of the adverse events associated with anti-EGFR therapy, oncology nurses have the potential to sustain patient adherence to completion of treatment, identify signs and symptoms early, proactively manage adverse events, and provide appropriate treatment interventions, thereby improving patient quality of life. (C) 2010 Elsevier Ltd. All rights reserved.