Cetuximab-Induced Hypomagnesemia in Patients with Colorectal Cancer

Fakih, Marwan; Wilding, Gregory E.; Lombardo, Jeffrey

doi:10.3816/ccc.2006.n.033

Cited by 103 publications

(71 citation statements)

References 9 publications

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“…Oral supplementation may be ineffective, then i.v. magnesium sulpfhate will easily normalize the condition (Fakih et al, 2006).…”

Section: Role Of Antibody Therapy P Pfeiffer Et Almentioning

confidence: 98%

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Current role of antibody therapy in patients with metastatic colorectal cancer

2007

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“…Oral supplementation may be ineffective, then i.v. magnesium sulpfhate will easily normalize the condition (Fakih et al, 2006).…”

Section: Role Of Antibody Therapy P Pfeiffer Et Almentioning

confidence: 98%

“…Grade 3-4 hypomagnesemia has been observed in as many as 25% of patients (Carson et al, 2005;Schrag et al, 2005;Fakih et al, 2006) and may augment nausea and fatigue. Oral supplementation may be ineffective, then i.v.…”

Section: Role Of Antibody Therapy P Pfeiffer Et Almentioning

confidence: 99%

Current role of antibody therapy in patients with metastatic colorectal cancer

2007

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“…Table III (17-29) shows the results of other studies regarding hypomagnesemia as a side-effect of cetuximab. In the available results of retrospective studies, the percentage of patients with any grade of hypomagnesemia varied from 6.3-93.3% with grade 3/4 in 0 to 27% (16,(25)(26)(27)(28)(29)(30). One of the first studies of this dyselectrolytemia associated with cetuximab by Fakih et al (14) showed a high incidence of grade 3 and 4 compared with later studies (27%).…”

Section: Discussionmentioning

confidence: 98%

“…Only one study estimated the level of grade 3/4 hypomagnesemia at 27% (30). Thus, it may be assumed that Mg depletion is a common, but not life-threatening complication in the population of patients treated with EGFR-targeting mAbs.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of frequency and severity of hypomagnesemia in patients with metastatic colorectal cancer treated with cetuximab, with a review of the literature

et al. 2015

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Abstract. Currently, there are a few systemic treatment options for patients with metastatic colorectal cancer (mCRC). Targeted therapy used in this setting includes the use of monoclonal antibodies, such as cetuximab or panitumumab, directed against epidermal growth factor receptor. The aim of the present study was to estimate the frequency and severity of hypomagnesemia among patients with mCRC treated with cetuximab. The data from the Department of Clinical Oncology, University Hospital of Krakow (Krakow, Poland), concerning 52 patients treated between 2009 and 2013 were collected. Of these, 27 patients fulfilled the inclusion criteria to enter this retrospective study. The National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 were used to grade the level of hypomagnesemia. In total, 29.6% of all patients experienced hypomagnesemia during treatment, and the majority of cases were grade 1 (22.2%). There was no statistically significant correlation between magnesium (Mg) level and patient age, duration of treatment, localization of primary tumor or metastases, and the number of metastases. However, there was an upward trend in a logistic regression model showing that the risk of developing hypomagnesemia increases with age. Hypomagnesemia is a frequent problem among mCRC patients receiving cetuximab. It is essential to introduce guidelines regarding the monitoring of the Mg level and its supplementation in this group of patients.

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Oral magnesium supplements for cancer treatment‐induced hypomagnesemia: Results from a pilot randomized trial

Awan

Basulaiman

Stober

et al. 2021

Health Science Reports

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Background and Aims Optimal management of cancer treatment‐induced hypomagnesemia (hMg) is not known. We assessed the feasibility of using a novel pragmatic clinical trials model to compare two commonly used oral Mg replacement strategies. Methods Patients with grade 1 to 3 hMg while receiving either platinum‐based chemotherapy or epidermal growth factor receptor inhibitors (EGFRI) were randomized to oral magnesium oxide (MgOx) or oral magnesium citrate (MgCit). The trial methodology utilized the integrated consent model. Feasibility would be successful if; accrual rate was ≥5 patients a month and if measures of patient and physician engagement, were > 50%. Secondary endpoints included; comparison of Mg levels, cardiac arrhythmias, and rates of treatment delay/hospitalizations. Results From July 2016 to December 2017, an average of 1 patient a month was accrued. All 15 eligible and approached patients consented to participate in the study (100% engagement) and 7/15 were randomized to MgOx and 8/15 to MgCit. The percentage of physicians who approached patients for the study was 4 of 6 (66.6% engagement). The mean slope of change in Mg (mmol/L/day) was 0.0022 (95% CI: −0.0001 to 0.0044) for MgOx and 0.0006 (95% CI, −0.0012 to 0.0024) for MgCit (P = .2123). Three patients (20%) required IV magnesium while on the study (2 MgCit and 1 MgOx). Grade 1 diarrhea occurred in 3 patients in the MgCit arm. Conclusion Despite oral magnesium tolerability and meeting most of its feasibility endpoints, this study did not meet its target accrual rate. Alternative designs would be necessary for a definitive efficacy study.

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Cetuximab-Induced Hypomagnesemia in Patients with Colorectal Cancer

Cited by 103 publications

References 9 publications

Current role of antibody therapy in patients with metastatic colorectal cancer

Current role of antibody therapy in patients with metastatic colorectal cancer

Assessment of frequency and severity of hypomagnesemia in patients with metastatic colorectal cancer treated with cetuximab, with a review of the literature

Oral magnesium supplements for cancer treatment‐induced hypomagnesemia: Results from a pilot randomized trial

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