This article will provide an overview of the principal toxicities associated with commonly used chemotherapy treatment regimens for metastatic colorectal cancer (mCRC) and explore the role of the oncology nurse in the management of treatment-associated toxicity. Although patients with mCRC have benefited considerably from recent therapeutic advances, the use of more complex treatment regimens has inevitably resulted in an increase in treatment-related toxicities. This can ultimately lead to dose reductions, delays, or discontinuation of therapy, which may negatively affect efficacy outcomes. Early identification and treatment of toxicities often can allow treatment to continue as planned or at a lower dose, if required. The oncology nurse is ideally positioned to assist with the timely recognition and management of side effects. This allows therapy to be continued on schedule and at the appropriate dose, enabling patients to achieve a better clinical outcome and maintain or improve their quality of life.

An overwhelming number of new agents, including targeted agents with unique mechanisms of action, are available in oncology practice today. Along with the benefit of new treatments for patients comes the unfamiliarity of associated toxicities and learning the best methods to minimize side effects. One such toxicity has been the spectrum of dermatologic reactions from some of the newer small-molecule inhibitors and monoclonal antibodies. Scientific evidence describing the unique rashes and methodologies to treat various cutaneous toxicities with specific agents is extremely limited. This article reviews the currently available literature related to dermatologic toxicities observed with many newer targeted therapies. Current recommendations for management are based on practices implemented during clinical trials and postmarketing practices. Additional research is needed to further elucidate the most efficacious methods for treating side effects observed with newer targeted therapies.

Technologies and cancer therapies develop at a rapid pace, which makes staying current with changes diffi cult for nurses. Newer cancer modalities combine surgery or interventional radiology techniques to deliver regional chemotherapy, limiting systemic toxicities. Chemotherapy-certifi ed nurses must be available to assist with chemotherapy administration in nontraditional areas. This article provides an overview of how clinical trials were implemented using newer modalities that integrate surgery or interventional radiology to deliver regional chemotherapy in a research setting in a safe, effective manner.

Oncology nurses must grasp a widening array of therapeutic options for cancer patients. The educational needs of the patient will be better met through a thorough understanding of basic concepts of newer cancer therapies.

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