European Journal of Oncology Nursing
Volume 14, Issue 4 , Pages 337-349 , September 2010

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

  • Jan Ouwerkerk

      Affiliations

    • Department of Clinical Oncology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
    • Corresponding Author InformationCorresponding author. Tel.: +31 71 5261965; fax: +31 71 5266725.
  • ,
  • Christine Boers-Doets

      Affiliations

    • Waterland Hospital, Purmerend, The Netherlands

References 

  1. Agero A, Dusza SW, Benvenuto-Andrade C, Busam KJ, Myskowski P, Halpern AC. Dermatologic side effects associated with the epidermal growth factor receptor inhibitors. Journal of the American Academy of Dermatology. 2006;55:657–670
  2. Amado RG, Wolf M, Peeters M, Van Cutsem E, Siena S, Freeman DJ, et al. Wild-type KRAS is required for panitumumab efficacy in patients with metastatic colorectal cancer. Journal of Clinical Oncology. 2008;26:1626–1634
  3. Basti S. Ocular toxicities of epidermal growth factor receptor inhibitors and their management. Cancer Nursing. 2007;30:S10–S16
  4. Benvenuti S, Sartore-Bianchi A, Di Nicolantonio F, Zanon C, Moroni M, Veronese S, et al. Oncogenic activation of the RAS/RAF signaling pathway impairs the response of metastatic colorectal cancers to anti-epidermal growth factor receptor antibody therapies. Cancer Research. 2007;67:2643–2648
  5. Berlin J, Van Cutsem E, Peeters M, Hecht JR, Ruiz R, Wolf M, et al. Predictive value of skin toxicity severity for response to panitumumab in patients with metastatic colorectal cancer (mCRC): a pooled analysis of five clinical trials. Journal of Clinical Oncology. 2007;25:18s;(abstr 4134)
  6. Boers-Doets, C., Ouwerkerk, J., August 17–21, 2008. EGFR-Inhibitors induced skin reactions. Presented at the International Society of Nurses in Cancer Care Conference, Singapore, China.
  7. Bokemeyer C, Bondarenko I, Makhson A, Hartmann JT, Aparicio J, de Braud F, et al. Fluorouracil, leucovorin, and oxaliplatin with and without cetuximab in the first-line treatment of metastatic colorectal cancer. Journal of Clinical Oncology. 2009;27:663–671
  8. Boone SL, Rademaker A, Liu D, Pfeiffer C, Mauro DJ, Lacouture ME. Impact and management of skin toxicity associated with anti-epidermal growth factor receptor therapy: survey results. Oncology. 2007;72:152–159
  9. Bouche O, Brixi-Benmansour H, Bertin A, Perceau G, Lagarde S. Trichomegaly of the eyelashes following treatment with cetuximab. Annals of Oncology. 2005;16:1711–1712
  10. Burtness B, Anadkat M, Basti S, Hughes M, Lacouture ME, McClure JS, et al. NCCN Task Force Report: management of dermatologic and other toxicities associated with EGFR inhibition in patients with cancer. Journal of the National Comprehensive Cancer Network. 2009;7(Suppl. 1):S5–S21quiz S22–S24
  11. Carson EJ, Novak AM, Stella PJ. Hypomagnesemia in patients with stage IV colorectal cancer treated with cetuximab as a single agent. Journal of Clinical Oncology. 2005;23(Suppl. 16s):(abstr 3655)
  12. Chung KY, Shia J, Kemeny NE, Shah M, Schwartz GK, Tse A, et al. Cetuximab shows activity in colorectal cancer patients with tumors that do not express the epidermal growth factor receptor by immunohistochemistry. Journal of Clinical Oncology. 2005;23:1803–1810
  13. Ciardiello F, Tortora G. EGFR antagonists in cancer treatment. New England Journal of Medicine. 2008;358:1160–1174
  14. Cunningham D, Humblet Y, Siena S, Khayat D, Bleiberg H, Santoro A, et al. Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. New England Journal of Medicine. 2004;351:337–345
  15. Dick SE, Crawford GH. Managing cutaneous side effects of epidermal growth factor receptor (HER2/EGFR) inhibitors. Community Oncology. 2005;2:492–496
  16. Di Fiore F, Blanchard F, Charbonnier F, Le Pessot F, Lamy A, Galais MP, et al. Clinical relevance of KRAS mutation detection in metastatic colorectal cancer treated by cetuximab plus chemotherapy. British Journal of Cancer. 2007;96:1166–1169
  17. Douillard JY, Cunningham D, Roth AD, Navarro M, James RD, Karasek P, et al. Irinotecan combined with fluorouracil compared with fluorouracil alone as the first-line treatment for metastatic colorectal cancer. A multicentre randomised trial. Lancet. 2000;355:1041–1047
  18. Dranko S, Kinney C, Ramanathan RK. Ocular toxicity related to cetuximab monotherapy in patients with colorectal cancer. Clinical Colorectal Cancer. 2006;6:224–225
  19. Dueland S, Sauer T, Lund-Johansen F, Ostenstad B, Tveit KM. Epidermal growth factor receptor inhibitor induces trichomegaly. Acta Oncology. 2003;42:345–346
  20. Erbitux (Cetuximab) Prescribing Information. Available from: Branchburg, NJ: Bristol-Meyers Squbb; 2008;http://packageinserts.bms.com/pi/pi_erbitux.pdf(accessed 9 July 2009)
  21. Erbitux (Cetuximab) Summary of Product Characteristics. Darmstadt, Germany: Merck KGaA; 2009;http://www.emea.europa.eu/humandocs/PDFs/EPAR/erbitux/H-558-PI-en.pdfAvailable from:(accessed 11 November 2008)
  22. Fakih MG, Wilding G, Lombardo J. Cetuximab-induced hypomagnesaemia in patients with colorectal cancer. Clinical Colorectal Cancer. 2006;6:152–156
  23. Foerster CG, Cursiefen C, Kruse FE. Persisting corneal erosion under cetuximab (Erbitux) treatment (epidermal growth factor receptor antibody). Cornea. 2008;27:612–614
  24. Galimont-Collen AFS, Vos LE, Lavrijsen APM, Ouwerkerk J, Gelderblom H. Classification and management of skin, hair, nail, and mucosal side-effects of epidermal growth factor receptor (EGFR) inhibitors. European Journal of Cancer. 2007;43:845–851
  25. Greil R, Letocha H, Gamelin E, Thaler J, Hofheinz R, Mineur L, et al. Updated analysis of a phase II study (20060314) of panitumumab (pmab) with FOLFIRI as first-line treatment of patients (pts) with metastatic colorectal cancer (mCRC). Journal of Clinical Oncology. 2009;27(Suppl. 15s):(abstr 4085)
  26. Grothey A. Recognizing and managing toxicities of molecular targeted therapies for colorectal cancer. Oncology (Williston Park). 2006;20:21–28
  27. Grothey A, Sargent D, Goldberg RM, Schmoll HJ. Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment. Journal of Clinical Oncology. 2004;22:1209–1214
  28. Hecht, J., Mitchell, E.P., Baranda, J., Richards, D., Reiner, M., Stout, S., Amado, R.G., 2008. Panitumumab (pmab) efficacy in patients (pts) with metastatic colorectal cancer (mCRC) with low or undetectable levels of epidermal growth factor receptor (EGFr): final efficacy and KRAS analyses. In: Presented at the 2008 American Society of Clinical Oncology Gastrointestinal Cancers Symposium, January 25–27, 2008; Orlando, FL (abstract 343).
  29. Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. New England Journal of Medicine. 2004;350:2335–2342
  30. Jatoi A, Rowland K, Sloan JA, Gross HM, Fishkin PA, Kahanic SP, et al. Tetracycline to prevent epidermal growth factor receptor inhibitor-induced skin rashes: results of a placebo-controlled trial from the North Central Cancer Treatment Group (N03CB). Cancer. 2008;113:847–853
  31. Jean GW, Shah SR. Epidermal growth factor receptor monoclonal antibodies for the treatment of metastatic colorectal cancer. Pharmacotherapy. 2008;28:742–754
  32. Jonker DJ, O’Callaghan CJ, Karapetis CS, Zalcberg JR, Tu D, Au HJ, et al. Cetuximab for the treatment of colorectal cancer. New England Journal of Medicine. 2007;357:2040–2048
  33. Kang SP, Saif MW. Infusion-related and hypersensitivity reactions of monoclonal antibodies use to treat colorectal cancer—identification, prevention, and treatment. The Journal of Supportive Oncology. 2007;5:451–457
  34. Karapetis CS, Khambata-Ford S, Jonker DJ, O’Callaghan CJ, Tu D, Tebbutt NC, et al. K-ras mutations and benefit from cetuximab in advanced colorectal cancer. New England Journal of Medicine. 2008;359:1757–1765
  35. Lacouture, M.E. Mitchell, E.P., Shearer, H., Iannotti, N., Piperdi, B., Pillai, M.V., Xu, F., Yassine, M., 2009. Impact of pre-emptive skin toxicity (ST) treatment (tx) on panitumumab (pmab)-related skin toxicities and quality of life (QOL) in patients (pts) with metastatic colorectal cancer (mCRC): results from STEPP. Presented at the American Society of Clinical Oncology Gastrointestinal Cancers Symposium, January 15–17, 2009; San Francisco, CA (abstract 291).
  36. Lacouture ME. Insights into the pathophysiology and management of dermatologic toxicities to EGFR-targeted therapies in colorectal cancer. Cancer Nursing. 2007;30:S17–S25
  37. Lacouture ME, Basti S, Patel J, Benson A. The SERIES clinic: an interdisciplinary approach to the management of toxicities of EGFR inhibitors. The Journal of Supportive Oncology. 2006;4:236–238
  38. Lee JJ, Chu E. First-line use of anti-epidermal growth factor receptor monoclonal antibodies in metastatic colorectal cancer. Clinical Colorectal Cancer. 2007;6:S42–S46
  39. Lemmens, L., 2008. Personalised cancer therapy: what is KRAS and what does it mean for patients with metastatic colorectal cancer? EONS Newsletter. Fall, 28–31.
  40. Lenz HJ, Van Cutsem E, Khambata-Ford S, Mayer RJ, Gold P, Stella P, et al. Multicenter phase II and translational study of cetuximab in metastatic colorectal carcinoma refractory to irinotecan, oxaliplatin, and fluoropyrimidines. Journal of Clinical Oncology. 2006;24:4914–4921
  41. Lievre A, Bachet JB, Boige V, Cayre A, Le Corre D, Buc E, et al. KRAS mutations as an independent prognostic factor in patients with advanced colorectal cancer treated with cetuximab. Journal of Clinical Oncology. 2008;26:374–379
  42. Lynch TJ, Kim ES, Eaby B, Garey J, West DP, Lacouture ME. Epidermal growth factor receptor inhibitor-associated cutaneous toxicities: an evolving paradigm in clinical management. Oncologist. 2007;12:610–621
  43. Melosky B, Burkes R, Rayson D, Alcindor T, Shear N, Lacouture M. Management of skin rash during EGFR-targeted monoclonal antibody treatment for gastrointestinal malignancies: Canadian recommendations. Current Oncology. 2009;16:16–26
  44. Common Toxicity Criteria for Adverse Events (CTCAE) Version 4.0. National Cancer Institute; 2009;http://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcaev4.pdfAvailable from:(accessed November 15, 2009)
  45. Oishi K. Clinical approaches to minimize rash associated with EGFR inhibitors. Oncology Nursing Forum. 2008;35:103–111
  46. Peeters M, Wilson G, Ducreux M, Cervantes A, André T, Hotko Y, et al. Phase III study (20050181) of panitumumab (pmab) with FOLFIRI versus FOLFIRI alone as second-line treatment (tx) in patients (pts) with metastatic colorectal cancer (mCRC): pooled safety results. Journal of Clinical Oncology. 2008;26(Suppl. 15s):(abstr 4064)
  47. Perez-Soler R, Delord JP, Halpern A, Kelly K, Krueger J, Sureda BM, et al. HER1/EGFR inhibitor-associated rash: future directions for management and investigation outcomes from the HER1/EGFR inhibitor rash management forum. Oncologist. 2005;10:345–356
  48. Peréz-Soler R, Saltz L. Cutaneous adverse effects with HER1/EGFR-targeted agents: is there a silver lining?. Journal of Clinical Oncology. 2005;23:5235–5246
  49. Pohl A, Zhang W, Ning Y, Manegold PC, Lurje G, Lenz H-J. Targeting metastatic colorectal cancer in 2008: a long way from 5-FU. Oncology. 2008;22:456–462
  50. Saltz LB. Understanding and managing chemotherapy-induced diarrhea. The Journal of Supportive Oncology. 2003;1:35–46
  51. Saltz LB, Cox JV, Blanke C, Rosen LS, Fehrenbacher L, Moore MJ, et al. Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. New England Journal of Medicine. 2000;343:905–914
  52. Saltz LB, Lenz HJ, Kindler HL, Hochster HS, Wadler S, Hoff PM, et al. Randomized phase II trial of cetuximab, bevacizumab, and irinotecan compared with cetuximab and bevacizumab alone in the irinotecan-refractory colorectal cancer. Journal of Clinical Oncology. 2007;25:4557–4561
  53. Saltz LB, Meropol NJ, Loehrer PJ, Needle MN, Kopit J, Mayer RJ. Phase II trial of cetuximab in patients with refractory colorectal cancer that expresses the epidermal growth factor receptor. J. Clin. Oncol. 2004;22:1201–1208
  54. Schrag D, Chung KY, Flombaum C, Saltz L. Cetuximab therapy and symptomatic hypomagnesemia. Journal of National Cancer Institute. 2005;97:1221–1224
  55. Scope A, Agero AL, Dusza SW, Myskowski PL, Lieb JA, Saltz L, et al. Randomized double-blind trial of prophylactic oral minocycline and topical tazarotene for cetuximab-associated acne-like eruption. Journal of Clinical Oncology. 2007;25:5390–5396
  56. Segaert S, Chiritescu G, Lemmens L, Dumon K, Van Cutsem E, Tejpar S. Skin toxicities of targeted therapies. European Journal of Cancer. 2009;45(Suppl. 1):295–308
  57. Siena S, Sartore-Bianchi A, Di Nicolantonio F, Balfour J, Bardelli A. Biomarkers predicting clinical outcome of epidermal growth factor receptor-targeted therapy in metastatic colorectal cancer. Journal of National Cancer Institute. 2009;101:1308–1324
  58. Siena S, Tabernero J, Burkes RL, Cassidy J, Cunningham D, Barugel ME, et al. Phase III study (PRIME/20050203) of panitumumab (pmab) with FOLFOX compared with FOLFOX alone in patients (pts) with previously untreated metastatic colorectal cancer (mCRC): pooled safety data. Journal of Clinical Oncology. 2008;26(Suppl. 15s):(abstr 4034)
  59. Sipples R. Common side effects of anti-EGFR therapy: acneform rash. Seminars in Oncology Nursing. 2006;22:28–34
  60. Sobrero AF, Maurel J, Fehrenbacher L, Scheithauer W, Abubakr YA, Lutz MP, et al. EPIC: phase III trial of cetuximab plus irinotecan after fluoropyrimidine and oxaliplatin failure in patients with metastatic colorectal cancer. Journal of Clinical Oncology. 2008;26:2311–2319
  61. Tournigand C, Andre T, Achille E, Lledo G, Flesh M, Mery-Mignard D, et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer. A randomized GERCOR study. Journal of Clinical Oncology. 2004;22:229–237
  62. Vaccaro M, Pollicino A, Barbuzza O, Guarneri B. Trichomegaly of the eyelashes following treatment with cetuximab. Clinical and Experimental Dermatology. 2009;34:402–403
  63. Van Cutsem E, Köhne CH, Hitre E, Zaluski J, Chang Chien CR, Makhson A, et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. New England Journal of Medicine. 2009;360:1408–1417
  64. Van Cutsem E, Peeters M, Siena S, Humblet Y, Hendlisz A, Neyns B, et al. Open-label phase III trial of panitumumab plus best supportive care compared with best supportive care alone in patients with chemotherapy-refractory metastatic colorectal cancer. Journal of Clinical Oncology. 2007;25:1658–1664
  65. Vano-Galvan S, Moreno-Martin P, Jaén P. Progressive trichomegaly. The Netherlands Journal of Medicine. 2009;67:35–36
  66. Vectibix (Panitumumab) Prescribing Information. Available from: Thousand Oaks, CA: Amgen, Inc.; 2008;http://www.vectibix.com/pdfs/misc/vectibix_pi.pdf(accessed 9 July 2009)
  67. Vectibix (Panitumumab) Summary of Product Characteristics. Available from: Breda, The Netherlands: Amgen Europe BV; 2009;http://www.emea.europa.eu/humandocs/PDFs/EPAR/vectibix/H-741-PI-en.pdf(accessed 11 November 2008)
  68. Viale PH, Sommers R. Nursing care of patients receiving chemotherapy for metastatic colorectal cancer: implications of the treatment continuum concept. Seminars in Oncology Nursing. 2007;23:22–35
  69. Wu M, Rivkin A, Pham T. Panitumumab: human monoclonal antibody against epidermal growth factor receptors for the treatment of metastatic colorectal cancer. Clinical Therapeutics. 2008;30:14–30
  70. Zhang G, Basti S, Jampol LM. Acquired trichomegaly and symptomatic external ocular changes in patients receiving epidermal growth factor receptor inhibitors: case reports and a review of the literature. Cornea. 2007;26:858–860
  71. Zhang W, Gordon M, Lenz HJ. Novel approaches to treatment of advanced colorectal cancer with anti-EGFR monoclonal antibodies. Annals of Medicine. 2006;38:545–551
  72. Zuckerman DS, Clark JW. Systemic therapy for metastatic colorectal cancer: current questions. Cancer. 2008;112:1879–1891

PII: S1462-3889(10)00058-X

doi: 10.1016/j.ejon.2010.03.004

European Journal of Oncology Nursing
Volume 14, Issue 4 , Pages 337-349 , September 2010