I. Overview
of Adverse Reactions of Tumor Targeting Drugs
Tumor-targeted drugs play an important role in cancer therapy and bring new hope to many patients. However, just like other drugs, tumor-targeted drugs are not without drawbacks, and they have a variety of adverse reactions. Different tumor-targeted drugs have different adverse reactions due to their different mechanisms of action. Common adverse reactions include rash, mucosal injury, hypertension, gastrointestinal reactions, renal damage, cardiotoxicity and so on. For example, tumor-targeted drugs may lead to rashes, and the skin of patients will show various abnormal manifestations, which seriously affect the quality of life. Mucosal injury may be manifested as oral mucosal ulcers, causing pain and difficulty in eating, and intestinal mucosal injury may also cause diarrhea and other symptoms. Angiogenesis inhibitors in targeted drugs are prone to induce hypertension, and blood pressure changes need to be closely monitored during treatment. In addition, cardiac toxicity may cause arrhythmia, and renal damage may lead to proteinuria and hematuria.
In a word, although tumor-targeted drugs have significant effects in the treatment of cancer, patients need to pay close attention to the possible adverse reactions in the process of using them, so as to take appropriate measures in time. 2. Types
of common adverse reactions
(I) Skin related reaction
Rash is one of the common skin-related adverse reactions of tumor-targeted drugs. Mild rashes are usually manifested as local skin redness, slight itching, etc., and generally do not require special treatment. Moderate and severe rashes may cause large areas of erythema, increased itching, and even pustules. For moderate and severe rashes, hormone or erythromycin ointment can be used under the guidance of doctors. In addition, some targeted drugs may also lead to dry skin, chapped skin, pigmentation, hair loss and other problems. Patients in the course of medication should pay attention to observe skin changes, keep the skin clean, avoid scratching, in order to avoid infection.
(2) Gastrointestinal reactions
Diarrhea is a common symptom of gastrointestinal reactions. Mild diarrhea generally does not affect daily life, but can be alleviated by adjusting diet, such as avoiding greasy, spicy and stimulating food, and increasing dietary fiber intake. If diarrhea is relatively severe, you can take some antidiarrheal drugs under the guidance of a doctor. Taking medicine after meals or taking medicine to protect gastric mucosa can prevent gastrointestinal reactions to a certain extent. In addition, nausea, vomiting and abdominal distension are also common gastrointestinal adverse reactions. For nausea and vomiting, it can be alleviated by bed rest, acupoint treatment, eating soda biscuits or sour preserves. Abdominal distension can be treated by clockwise massage of the abdomen and medication.
(3) Liver function damage
Tumor-targeted drugs may cause liver damage. Patients with mild hepatic impairment may have no obvious symptoms, or only show mild elevation of liver enzyme. At this time, you can take enzyme lowering drugs to protect liver function, and regularly review liver function. If the liver function continues to be poor, very serious, and the use of drugs to protect the liver has no effect, it may be necessary to stop taking drugs and change them under the guidance of a doctor.
(IV) Cardiotoxicity
Cardiotoxicity is one of the most serious adverse reactions of tumor-targeted drugs. Possible symptoms include hypertension, myocardial ischemia, arrhythmia and so on. Angiogenesis inhibitors and some targeted drugs may induce hypertension, and patients need to closely monitor blood pressure changes in the course of treatment, which can be treated with angiotensin-converting enzyme inhibitors and calcium channel blockers. Arrhythmias such as bradycardia and arrhythmia may also occur. QTc interval prolongation is a side effect of some targeted drugs. Predisposing factors include genetic factors and acquired causes, such as electrolyte disorders, drug induction and so on. (V) Pulmonary toxicity
Pulmonary toxicity may cause fever, cough, expiratory dyspnoea and other symptoms. Acute or subacute pneumonia has been reported in some targeted therapies, such as gefitinib and erlotinib, with an incidence of about 1% and a certain lethality. Risk factors include advanced age, PS score difference, smoking, and short time to diagnosis of cancer. Treatment includes discontinuation, supportive care, and corticosteroids for critically ill patients. Targeted drugs can be used again after discontinuation of the drug, which can be reduced or glucocorticoids can be used at the same time, but pneumonia may recur.
(VI) Other adverse reactions
In addition to the above common adverse reactions, tumor-targeted drugs may also cause oral mucositis, paronychia and so on. Oral mucositis is characterized by ulceration of the oral mucosa, which causes pain and difficulty in eating. Paronychia can cause swelling, pain and other symptoms around the nails. In addition, bone marrow suppression is also one of the possible side effects, such as thrombocytopenia, anemia, leukopenia, etc. Patients need regular blood tests. Hair loss is also one of the adverse reactions of some targeted drugs, patients may have thinning hair, hair loss and so on.
III. Adverse Reaction Case Warning
(1) Risk
of online purchase of targeted drugs Uncle Zhang, in his
50s, had lung cancer for more than two years, and his daughter bought a targeted drug for him online. As a result, after eating for less than half a month, not only did the tumor not shrink, but also a rash grew all over the face, as dense as rust, and the pain and itching were unbearable. This is a typical drug-induced rash, and the most important thing now is to stop the current drug treatment and deal with the side effects of the rash. This case fully shows that there are great risks in purchasing targeted drugs online. First of all, the treatment of tumors is very complex, different types of tumors, different stages and the physical condition of patients require different treatment methods. Secondly, the treatment of cancer is a systematic project, which requires the whole process of management and precise treatment. Self-medication is likely to choose the wrong drug, which not only fails to achieve therapeutic effect, but also may bring serious adverse reactions. Therefore, for the treatment of cancer, it is recommended to find a special department and need the help of professional doctors, rather than simply searching the Internet and self-medication.
(2) Pain
of serious side effects After being diagnosed with cancer, Ms.
Yu began to take targeted drugs for treatment. Soon after, however, she developed a severe rash and other side effects. Her skin showed a large area of erythema and itching, which seriously affected her quality of life. At the same time, she also suffered from diarrhea, nausea and other gastrointestinal reactions, which made her miserable. Faced with these serious side effects, Ms. Yu carried out comprehensive treatment under the guidance of doctors. For the rash, the doctor used hormones and erythromycin ointment to treat it, and told her to keep her skin clean and avoid scratching. For gastrointestinal reactions, the doctor adjusted her diet so that she could avoid eating greasy, spicy and stimulating food and increase the intake of dietary fiber. At the same time, the doctor also prescribed antidiarrheal drugs and drugs to protect the gastric mucosa. After a period of treatment, Ms. Yu’s side effects have been alleviated to a certain extent. But she also deeply realized that although tumor-targeted drugs have some effect in the treatment of cancer, they may also bring serious side effects. In the process of using targeted drugs, we must pay close attention to our physical condition and give timely feedback to doctors so as to take effective treatment measures.
4. Correctly deal with adverse reactions
Adverse reactions
of tumor-targeted drugs need to be handled correctly to ensure the quality of life and therapeutic effect of patients in the course of treatment. The more standardized and timely the treatment of adverse reactions, the less likely it is to delay normal anti-cancer treatment.
For mild adverse reactions, targeted treatment measures can be taken. For example, mild rashes do not require special treatment, but if itching or discomfort occurs, a little ointment similar to hormones or erythromycin can be used under the guidance of a doctor. Mild liver function damage, you can take some drugs to reduce enzymes, protect the liver function, and regularly review, if the liver function does not continue to deteriorate after taking the medicine, it is OK to continue taking the medicine. Mild diarrhea is not a big problem, you can adjust your diet, avoid eating greasy, spicy, stimulating food, increase the intake of dietary fiber, if diarrhea is relatively severe, you can take some antidiarrheal drugs.
However, when serious adverse reactions occur, the drug may have to be discontinued. Withdrawal is generally controlled in 7-14 days, generally after a period of withdrawal, the side effects will be significantly reduced. For example, severe rashes may require a reduction in the dose of molecularly targeted drugs and symptomatic treatment. When severe liver function damage occurs and the drugs used to protect the liver have no effect, the drug must be stopped and changed under the guidance of the doctor.
In a word, in the face of adverse reactions of tumor targeted drugs, patients should maintain a positive attitude, pay close attention to their physical condition, timely feedback to doctors, take standardized and timely treatment measures, and combine with traditional Chinese medicine for early intervention, in order to improve the quality of life and better carry out anti-cancer treatment.
