Management of Toxicities of Targeted Therapies

The document from January 1, 2018, provides an overview of the management of side effects from targeted therapies for lung cancer, including EGFR TKIs, ALK inhibitors, BRAF inhibitors, ROS1 inhibitors, antiangiogenesis agents, and anti-PD1 immunotherapy. Dermatologic and gastrointestinal side effects are common, with a notable incidence of skin rash in patients using EGFR inhibitors, leading to therapy interruption in 76% and discontinuation in 32% of cases. Diarrhea is also a frequent side effect, with varying incidences across different EGFR TKIs. Interstitial lung disease is a rare but serious side effect, with higher rates in Japan. Other side effects include QTc prolongation, hypertension, thromboembolic events, and autoimmune conditions. Ethnic differences in side effect incidence are noted, potentially due to genomic or clinical practice differences. Management strategies include the use of topical and systemic medications, dose adjustments, and preventive measures. The document also discusses hair abnormalities and extensive growth of eyelashes and eyebrows associated with certain EGFR inhibitors. The conclusion emphasizes that while targeted therapies are effective for advanced lung cancer, their side effects require early identification and appropriate management to ensure patient benefit.