Top Banner Top Banner

Tolerability of Antiangiogenic Therapy
Anyone who has received chemotherapy, or knows someone who has, is aware of the severe and often debilitating side effects associated with these powerful medications. This is because chemotherapy is non-specific—it targets both cancer cells and healthy cells. Antiangiogenic agents are generally much better tolerated than chemotherapy. Nonetheless, they still produce side effects, which must be carefully monitored and managed.

Elevated blood pressure (hypertension) is the most common side effect from angiogenesis inhibitors. Some patients may require treatment with standard blood pressure lowering medications, but most do not have to discontinue therapy because of this adverse effect. Another common side effect of antiangiogenic therapy is excess protein in the urine. This is usually mild and can generally be managed with dosing modifications.

Other serious but less frequent adverse effects from angiogenesis inhibitors include bleeding and coagulation problems, gastrointestinal perforation, delayed wound healing, and, very rarely, life-threatening hemorrhages. Skin reactions, particularly facial rash, are quite common in patients treated with EGFR inhibitors, such as cetuximab. Skin reactions are most pronounced in the first 2-3 weeks of treatment and are managed according to severity. Other adverse effects reported with EGFR inhibitors mouth sores, hair changes, and hypersensitivity infusion reactions.13 More recently, a condition of low magnesium levels in the blood, called hypomagnesemia, has been observed in patients receiving EGFR inhibitors. Patients on cetuximab are advised to have their serum magnesium levels monitored routinely, and hypomagnesemia should be considered in patients who develop fatigue and muscle weakness during therapy.


Last updated May 29, 2011