Diarrhea associated with afatinib: An oral ErbB family blocker
Journal
Expert Review of Anticancer Therapy
Journal Volume
13
Journal Issue
6
Pages
729-736
Date Issued
2013
Author(s)
Reguart N
Barinoff J
Köhler J
Uttenreuther-Fischer M
Stammberger U
O'Brien D
Wolf J
Cohen E.E.
Abstract
Gastrointestinal (GI) adverse events (AEs) are frequently observed in patients receiving EGF receptor (EGFR; also known as HER1 or ErbB1) tyrosine kinase inhibitor therapy. GI AEs are among the most common and most impactful on a patient's quality of life. Severe diarrhea can result in fluid and electrolyte losses, leading to dehydration, electrolyte imbalances and renal insufficiency. Afatinib is an irreversible, oral, ErbB family blocker, inhibiting EGFR (ErbB1), HER2 (ErbB2) and ErbB4 receptor kinases. It also inhibits transphosphorylation of ErbB3. Similar to reversible tyrosine kinase inhibitors of EGFR, GI AEs-in particular, diarrhea-have frequently been observed in afatinib-treated patients. This article summarizes current data on afatinib-associated diarrhea and provides strategies for its management. Patient education, early identification, timely management and ongoing assessment will help to prevent aggravation, afatinib dose reductions or therapy discontinuation, encouraging patient compliance and allowing patients to obtain the maximum therapeutic benefit from this agent. ? 2013 2013 Expert Reviews Ltd.
Subjects
afatinib; afatinib-associated adverse event; diarrhea; EGF receptor; gastrointestinal adverse event
SDGs
Other Subjects
afatinib; antibiotic agent; antineoplastic agent; dacomitinib; epidermal growth factor receptor; epidermal growth factor receptor 2; epidermal growth factor receptor 4; erlotinib; gefitinib; lapatinib; loperamide; neratinib; non prescription drug; placebo; breast cancer; cancer combination chemotherapy; cancer patient; constipation; diarrhea; diet therapy; disease severity; drug dose escalation; drug dose reduction; drug efficacy; drug mechanism; drug megadose; drug safety; drug use; drug withdrawal; human; lung non small cell cancer; monotherapy; nausea; nutritional deficiency; patient education; practice guideline; protein phosphorylation; quality of life; recommended drug dose; review; stomatitis; treatment response; vomiting; Administration, Oral; Diarrhea; Humans; Protein Kinase Inhibitors; Quinazolines; Receptor, Epidermal Growth Factor; Receptor, erbB-2
Type
Review