Proactive management of adverse events maintains the clinical benefit of ixabepilone
Yardley DA - Ixabepilone is an effective agent for treating advanced breast cancer, even in pts who experience disease progression following anthracycline, taxane, and capecitabine therapy. Although this agent is generally well tolerated, by effectively managing adverse events, clinicians can ensure that pts derive the maximum benefit whether given as a single agent or in combination with capecitabine. Methods- Article reviews the safety profile of single-agent ixabepilone and combination of ixabepilone plus capecitabine therapy
- Steps to effectively manage and prevent common adverse events are also outlined
Results- Ixabepilone is generally well tolerated; its toxicity profile does not overlap with that of capecitabine
- Common toxicities: peripheral sensory neuropathy and neutropenia
- AEs can be effectively managed by:
- monitoring patients and then
- depending on severity, instituting a treatment delay until recovery and
- reducing the ixabepilone dose for subsequent treatment cycles
- Ixabepilone dose reductions are recommended for most grade 3 events
- Treatment discontinuation is recommended for persistent grade 3 neuropathy or grade 4 nonhematological toxicity
- Because ixabepilone exposure is greater in pts with hepatic impairment, dose adjustments and restrictions are recommended according to the degree of hepatic impairment
- Pts should be premedicated with oral H1 and H2 antihistamines to prevent hypersensitivity reactions
[more...]
|
|
|
