- With Mayo Clinic medical oncologist
Timothy Moynihan, M.D.
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Timothy Moynihan, M.D.
Timothy Moynihan, M.D.
"As a practicing medical oncologist, I meet with patients and families every day to help manage their course through this disease called cancer. This experience provides unique insight into the needs of cancer patients, their families and loved ones and brings into sharp focus the need for reliable information to be readily available in terms that can be easily understood." — Dr. Timothy Moynihan
Dr. Timothy Moynihan believes that providing consumers accurate, timely information on the broad, complex topic of cancer is the biggest challenge facing medical Web sites. As the guiding force behind our cancer coverage, he makes sure Mayo Clinic meets the test.
Dr. Moynihan, born in Las Vegas, N.M., but raised in Denver, is a consultant in medical oncology at Mayo Clinic and an associate professor at Mayo Clinic College of Medicine. He is board certified in internal medicine, medical oncology, and hospice and palliative care medicine. He did his medical oncology training at Johns Hopkins Hospital in Baltimore, and then went on to the University of Minnesota and St. Paul Regions Medical Center in St. Paul, Minn., for seven years before moving to Mayo Clinic in 1999. Dr. Moynihan is director of the palliative care program at Mayo Clinic and associate medical director of the Mayo Clinic hospice.
Dr. Moynihan currently serves as the education chair for the Department of Medical Oncology and fellowship program director. Four times he has been selected as Teacher of the Year in medical oncology and elected to the Teacher of the Year Hall of Fame. Past honors include distinguished clinical teacher at the University of Minnesota Medical School, best internist at the Medical College of Wisconsin and recipient of The Upjohn Achievement Award for Excellence in Medicine. He serves on several national committees for the American Society of Clinical Oncology.
"The Internet provides a ready source of information on a wide range of topics of interest to those affected by cancer," Dr. Moynihan says. "The difficulty is trying to decide which sites provide reputable information and which information is relevant to each individual patient. The long history and tradition of excellence associated with Mayo Clinic assures you that information provided will be reliable, up-to-date and comprehensive."
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Question
EGFR inhibitor cancer therapy: What are the side effects?
Do EGFR inhibitor cancer therapies have side effects?
Answer
from Timothy Moynihan, M.D.
EGFR inhibitor stands for epidermal growth factor receptor inhibitor and is one type of newer targeted cancer treatments. Unlike more standard chemotherapy agents, which destroy both cancer cells and healthy cells, targeted therapies like EGFR inhibitors primarily attach to and destroy cancer cells. Because of this, EGFR inhibitor therapies have fewer broad-range side effects such as the nausea and vomiting, hair loss, and anemia sometimes associated with more traditional chemotherapy.
But EGFR inhibitor therapies do have side effects, including headache, diarrhea, infection and, most commonly, dry and itchy skin rashes. Such skin rashes are usually mild to moderate in intensity. However, they can be severe and include acne-like sores and pustules. This can cause discomfort and embarrassment, since they often appear on the face, neck and chest.
There are medications that have proved effective in treating skin rashes caused by EGFR inhibitors. Talk with your health care team about how a rash can be treated if you develop one. In addition, you may be asked to limit your exposure to the sun during treatment, and to watch for skin inflammation or infection. Your EGFR inhibitor treatment need not be stopped solely because you develop a rash.
EGFR inhibitors include erlotinib (Tarceva), cetuximab (Erbitux) and panitumumab (Vectibix).
Next questionGinger for chemotherapy-induced nausea: Does it work?
- Hu JC, et al. Cutaneous side-effects of epidermal growth factor receptor inhibitors: Clinical presentation, pathogenesis, and management. Journal of the American Academy of Dermatology. 2007;56:317.
- Oishi K. Clinial approaches to minimize rash associated with EGFR inhibitors. Oncology Nursing Forum. 2008;35:103.
- Eaby B, et al. An interdisciplinary consensus on managing skin reactions associated with human epidermal growth factor receptor inhibitors. Clinical Journal of Oncology Nursing. 2008;12:283.
- Jatoi A, et al. Do patients die from rashes from epidermal growth factor receptor inhibitors? A systemic review to help counsel patients about holding therapy. The Oncologist. 2008;13:1201.
- Erbitux (prescribing information). Branchburg, N.J.: ImClone Systems Inc.; 2008. http://packageinserts.bms.com/pi/pi_erbitux.pdf. Accessed May 21, 2009.
- Tarceva (prescribing information). Melville, N.Y.: OSI Pharmaceuticals Inc.; 2009. http://www.gene.com/gene/products/information/pdf/tarceva-prescribing.pdf. Accessed June 3, 2009.
- Vectibix (prescribing information). Thousand Oaks, Calif.: Amgen Inc.; 2008. http://www.vectibix.com/pdfs/misc/vectibix_pi.pdf. Accessed June 3, 2009.
- Tarceva: Managing Tarceva side effects. Melville, N.Y.: OSI Pharmaceuticals Inc.; 2009. http://www.tarceva.com/patient/taking/effects.jsp. Accessed June 3, 2009.
- Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. June 14, 2009.
