Department of Clinical Oncology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
Eur J Oncol Nurs. 2010 Sep;14(4):337-49. doi: 10.1016/j.ejon.2010.03.004. Epub 2010 May 23.
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.
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.
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.
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.
为肿瘤护士提供有关转移性结直肠癌患者中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相关毒性管理的概述。
针对 EGFR 的单克隆抗体（如西妥昔单抗和帕尼单抗）为转移性结直肠癌患者提供了有效的治疗选择。这两种抗体均可单独使用；西妥昔单抗也被批准与化疗联合使用。我们复习了有关这些药物相关的体征和症状、严重程度评估以及预防和管理不良事件的策略的文献。
这一类治疗药物的不良事件谱总体上可接受，与传统化疗药物明显不同。与引起骨髓抑制、黏膜炎和恶心呕吐的细胞毒性化疗不同，抗 EGFR 治疗中常见的毒性包括更频繁的皮肤毒性、电解质失衡和腹泻，以及不太常见的眼部毒性。嵌合单克隆抗体西妥昔单抗也会发生输注反应。
肿瘤护士在多药物治疗方案的管理中起着关键作用，尤其是在识别和管理毒性、患者教育和患者支持方面。通过减少与抗 EGFR 治疗相关的不良事件的发生率和严重程度，肿瘤护士有可能维持患者对治疗完成的依从性，及早发现体征和症状，主动管理不良事件，并提供适当的治疗干预措施，从而提高患者的生活质量。
