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- Title
NURSING IMPLICATIONS REGARDING THE MANAGEMENT OF SIDE EFFECTS IN A PHASE I STUDY USING GEFITINIB WITH RAPAMYCIN.
- Authors
Lyons, Peggy; Tourt-Uhlig, Sandra; Reardon, David
- Abstract
Small molecular targeting therapies, such as EGFR inhibitors and mTOR inhibitors, are becoming more common in investigational treatments for malignant gliomas and other cancers. As more information is discovered about inhibiting molecular signaling pathways in cells, combinations of these therapies are being studied in Phase 1 human trials. Through these combination therapy clinical trials, new information regarding toxicity profiles is emerging. In a Phase 1 study using Gefinitib and Rapamycin in patients with Malignant Glioma at Duke University Medical Center, numerous cases of mucositis were noted. Also, cases of fatigue and diarrhea occurred, which were noted to be more severe than the toxicity profile of patients treated with EGFR inhibitors alone. In addition, toxicities to Rapamycin may include hypertension, hypercholesterolemia and/or hyperlipidemia, which are not common toxicities encountered by oncology nurses. It is essential for nurses to be aware of the potential side effects associated with using Gefitinib in combination with Rapamycin and effective methods to manage these symptoms. This poster will inform oncology nurses of the common toxicities observed in this study. Tools developed for educating patients and providers will be demonstrated. Effective nursing management of these toxicities will be discussed. In this Phase 1 trial oral drug combination, (X#) patients with malignant gliomas were treated daily. Patients returned to clinic approximately every four weeks for toxicity assessment and were monitored throughout their treatment. Due to mucositis noted early in the study, a patient teaching sheet was developed and patients were educated prior to starting treatment. An aggressive mucositis management logarithm was developed with staff instructed on its use. As a result of this study, a toxicity profile and maximum tolerated dose level were discovered. In addition, patients were better educated regarding anticipating potential adverse events and self care strategies. Nurses played an integral role in improving quality of life and alleviating side effects for these study patients through upfront education, effective assessment, and appropriate intervention. Oncology nurses may encounter these toxicities in patients being treated with Gefitinib and Rapamycin. This information will assist nurses in developing treatment strategies to effectively manage these toxicities prior to the patients' initiating therapy.
- Publication
Oncology Nursing Forum, 2006, Vol 33, Issue 2, p406
- ISSN
0190-535X
- Publication type
Academic Journal