Targeted therapy-induced diarrhea: A review of the literature

M. A. Pessi; N. Zilembo; E. R. Haspinger; L. Molino; S. Di Cosimo; M. Garassino; C. I. Ripamonti

doi:10.1016/j.critrevonc.2013.11.008

Targeted therapy-induced diarrhea: A review of the literature

M. A. Pessi, N. Zilembo, E. R. Haspinger, L. Molino, S. Di Cosimo, M. Garassino, C. I. Ripamonti

Fondazione IRCCS Istituto Nazionale dei Tumori

Research output: Contribution to journal › Article › peer-review

Abstract

Purpose of research: Revision of the literature on targeted therapy-induced diarrhea (TT-ID). Principal results: TT-ID is frequent; the mechanisms are mainly secretive, followed by ischemic or autoimmune ones. The duration of TT-ID is protracted over time. Its intensity is of grade G1-G3 but may be fatal in patients with diffuse colitis or on ipilimumab. However, no specific guidelines are available on management of different grades of TT-ID. Preventive measures with antibiotics, probiotics or activated charcoal should be further investigated. Loperamide is the first choice drug followed by octreotide. The role of corticosteroids is controversial. Conclusion: Early assessment and management of TT-ID is essential to prevent the worsening of this side-effect, patients' hospitalization and dose reduction or oncological treatment discontinuation. Future research is needed to better understand the pathophysiological mechanisms of TT-ID and it should also be investigated whether a specific pharmacological and/or non pharmachological approach is indicated.

Original language	English
Pages (from-to)	165-179
Number of pages	15
Journal	Critical Reviews in Oncology/Hematology
Volume	90
Issue number	2
DOIs	https://doi.org/10.1016/j.critrevonc.2013.11.008
Publication status	Published - 2014

Keywords

Assessment
Diarrhea
Incidence
Targeted therapy
Treatment

ASJC Scopus subject areas

Oncology
Hematology
Geriatrics and Gerontology
Medicine(all)

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title = "Targeted therapy-induced diarrhea: A review of the literature",

abstract = "Purpose of research: Revision of the literature on targeted therapy-induced diarrhea (TT-ID). Principal results: TT-ID is frequent; the mechanisms are mainly secretive, followed by ischemic or autoimmune ones. The duration of TT-ID is protracted over time. Its intensity is of grade G1-G3 but may be fatal in patients with diffuse colitis or on ipilimumab. However, no specific guidelines are available on management of different grades of TT-ID. Preventive measures with antibiotics, probiotics or activated charcoal should be further investigated. Loperamide is the first choice drug followed by octreotide. The role of corticosteroids is controversial. Conclusion: Early assessment and management of TT-ID is essential to prevent the worsening of this side-effect, patients' hospitalization and dose reduction or oncological treatment discontinuation. Future research is needed to better understand the pathophysiological mechanisms of TT-ID and it should also be investigated whether a specific pharmacological and/or non pharmachological approach is indicated.",

keywords = "Assessment, Diarrhea, Incidence, Targeted therapy, Treatment",

author = "Pessi, {M. A.} and N. Zilembo and Haspinger, {E. R.} and L. Molino and {Di Cosimo}, S. and M. Garassino and Ripamonti, {C. I.}",

year = "2014",

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language = "English",

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AU - Pessi, M. A.

AU - Zilembo, N.

AU - Haspinger, E. R.

AU - Molino, L.

AU - Di Cosimo, S.

AU - Garassino, M.

AU - Ripamonti, C. I.

PY - 2014

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N2 - Purpose of research: Revision of the literature on targeted therapy-induced diarrhea (TT-ID). Principal results: TT-ID is frequent; the mechanisms are mainly secretive, followed by ischemic or autoimmune ones. The duration of TT-ID is protracted over time. Its intensity is of grade G1-G3 but may be fatal in patients with diffuse colitis or on ipilimumab. However, no specific guidelines are available on management of different grades of TT-ID. Preventive measures with antibiotics, probiotics or activated charcoal should be further investigated. Loperamide is the first choice drug followed by octreotide. The role of corticosteroids is controversial. Conclusion: Early assessment and management of TT-ID is essential to prevent the worsening of this side-effect, patients' hospitalization and dose reduction or oncological treatment discontinuation. Future research is needed to better understand the pathophysiological mechanisms of TT-ID and it should also be investigated whether a specific pharmacological and/or non pharmachological approach is indicated.

AB - Purpose of research: Revision of the literature on targeted therapy-induced diarrhea (TT-ID). Principal results: TT-ID is frequent; the mechanisms are mainly secretive, followed by ischemic or autoimmune ones. The duration of TT-ID is protracted over time. Its intensity is of grade G1-G3 but may be fatal in patients with diffuse colitis or on ipilimumab. However, no specific guidelines are available on management of different grades of TT-ID. Preventive measures with antibiotics, probiotics or activated charcoal should be further investigated. Loperamide is the first choice drug followed by octreotide. The role of corticosteroids is controversial. Conclusion: Early assessment and management of TT-ID is essential to prevent the worsening of this side-effect, patients' hospitalization and dose reduction or oncological treatment discontinuation. Future research is needed to better understand the pathophysiological mechanisms of TT-ID and it should also be investigated whether a specific pharmacological and/or non pharmachological approach is indicated.

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