Patient-reported symptoms and stepwise symptom management in patients on epidermal growth factor inhibitors: A retrospective, descriptive cohort study

Eur J Cancer Care (Engl). 2018 Mar;27(2):e12800. doi: 10.1111/ecc.12800. Epub 2018 Jan 4.

Abstract

Adverse events (AEs) of epidermal growth factor inhibitors (EGFRi) influence well-being with a risk to dose modifications (DMs). Hereby, clinical benefit of treatment might be affected. This retrospective cohort study was set up to gain insight into the suitability and added value of a patient-reported outcome measurement tool (PROM), together with a stepwise intervention management plan for EGFRi-related AEs in daily practice. The primary objective was to gain insight into total treatment duration and DMs, and the secondary objective to gain insight into patient-reported symptoms and well-being as well as healthcare professional-reported AEs. Sixty-eight patients on cetuximab and 19 on panitumumab treatment were included for analysis; 69% had squamous cell carcinoma of head and neck (SCCHN) and 26% metastatic colorectal carcinoma. DMs due to AEs occurred in 39% of the patients and dose discontinuations in 22%. Especially anorexia, dysphagia, oral pain and skin changes led to a decreased well-being. In patients on EGFRi, application of PROMs together with a stepwise symptom management plan enhances early recognition of symptom burden, pro-active symptom management and effect evaluation of interventions performed whereby well-being recovers. Since only SCCHN patients discontinued treatment due to AEs, patient-centred care focused on radiotherapy-related AEs, creates opportunities for amelioration.

Keywords: EGFR inhibitor; cancer; patient reported outcome; symptom management; symptom monitoring; targeted therapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal / adverse effects*
  • Antineoplastic Agents, Immunological / adverse effects*
  • Carcinoma / drug therapy*
  • Cetuximab / adverse effects*
  • Colorectal Neoplasms / drug therapy*
  • Epidermal Growth Factor / adverse effects*
  • Female
  • Head and Neck Neoplasms / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Panitumumab
  • Retrospective Studies

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents, Immunological
  • epidermal growth inhibitors
  • Epidermal Growth Factor
  • Panitumumab
  • Cetuximab