onco adverse effects

Allopurinol

• Hypersensitivity

Rasburicase

• Methemoglobinemia​

• Hemolysis in G6PD deficiency

Ipilimumab

• GI

• Dermatologic

• Hypophysitis

Pembrolizumab

• Pneumonitis​

• Thyroiditis

Typical Onset of irAEs​

1. Rash

2. Diarrhea

3. Hypophysitis / Liver toxicicity

Bisphosphonates

• Osteonecrosis of the Jaw (ONJ)

Denosumab

• Hypocalcemia​

Calcitonin

• Tachyphylaxis (stops working after ~48 hrs)

5HT3 Receptor Antagonists​

• QTc prolongation​

Olanzapine

• EPS

• Weight gain​

• Hyperglycemia

NK1 Receptor Antagonists​

• Hiccups

Corticosteroids

• Hyperglycemia

Benzodiazepines

• Respiratory depression

• Anterograde amnesia

Cannabinoids

• Elation (euphoria)

Anticholinergic

• Can’t shit

• Can’t spit

• Can’t pee

• Cant’t see

Palifermin

• Dysgeusia (taste changes)

Cisplatin

• Nausea/Vomiting (high)

• Nephrotoxicity

• Peripheral neuropathy

• Ototoxicity

• Ocular toxicity

Carboplatin

• Myelosuppression (more compared to cisplatin)

• Hematological toxicity

• Hypersensitivity

Docetaxel​

• Hepatic function impairment

• Neutropenia

• Peripheral neuropathy

Paclitaxel

• Hypersensitivity (due to cremophor)

• Peripheral neuropathy (more than docetaxel)

Gemcitabine

• Pulmonary toxicity

Pemetrexed

• SJS/TEN (severe skin reaction)

• Pulmonary toxicity

Amivantamab

• Rash (SJS/TEN)

• VTE (in combo with Lazertinib)

Erlotinib / Gefitinib

• Rash

• Paronychia

• Interstitial lung disease​

Afatinib

• Rash

• Paronychia

• Interstitial lung disease​

• HFrEF

• Diarrhea (worst in first 6 weeks)

Osimertinib

• QT prolongation

• HFrEF

• Pulmonary embolism

Lazertinib

• Rash (SJS/TEN)

• VTE

Crizotinib

• Bradycardia

• Vision disorders

Ceritinib

• Bradycardia

• Hyperglycemia

• Pancreatitis

Alectinib

• Bradycardia

• Myalgia

• CPK elevation

• Photosensitvity

Larotrectinib

• Neurotoxicity

Entrectenib

• Heart failure

• Fractures

• Hyperuricemia and TLS​

Dabrafenib/Trametinib

• Cardiomyopathy

• Cutaneous squamous cell carcinoma

• VTE

• Fever

• Retinal detachment

Encorafenib/Binimetinib​

• Cardiomyopathy

• Cutaneous squamous cell carcinoma

• VTE

• Fever

• Retinal detachment

Vemurafenib/Cobimetinib​

• Cardiomyopathy

• Cutaneous squamous cell carcinoma

• VTE

• Fever

• Retinal detachment

Oxaliplatin

• Cold - Induced neuropathy

Bevacizumab

• GI perforation​

• Bleeding

• Proteinuria

• STOP IF:

  • SBP: >150

  • DBP: >100

  • PROTEINURIA

Ramucirumab

• Bleeding

• GI perforation

• Arterial thrombosis

• Hypothyroidism

Cetuximab

• Cardiopulmonary arrest

• Infusion reactions

• Hair changes (facial hypertrichosis/ trichomegaly)

• Paronychia

Panitumumab

• Dermatologic toxicity

• Hair changes (facial hypertrichosis/ trichomegaly)

• Paronychia

5-Fluorouracil

• DPD deficiency → SEVERE toxicity

• Warfarin interaction → ↑ INR

• Bolus:

  • Mylosupression

• Continuous Infusion:

  • Hand foot syndrome

  • Diarrhea

  • Mucositis

Irinotecan

• Diarrhea

Capecitabine

• Hand-foot syndrome

• Cardiotoxicity

Regorafenib

• Hepatotoxicity

• Hand foot skin reaction

• Hemorrhage

• Gastrointestinal perforation and/or fistula​

Trastuzumab

• Cardiomyopathy

• Infusion reactions​

• Pulmonary toxicity

Pertuzumab

• Cardiomyopathy

• Diarrhea

Tamoxifen

• VTE

• Uterine sarcoma ​

• Endometrial cancer

Aromatase Inhibitors​

• Osteoporosis

Palbociclib

• Neutropenia

• Thrombocytopenia

Ribociclib ​

• Neutropenia

• Thrombocytopenia

• Prolonged QT

Abemaciclib

• Fatigue

• Diarrhea​

• VTE

Lapatinib

• Hepatotoxicity

Olaparib

• Interstitial lung disease

• Secondary malignancy

Talazoparib

• Secondary malignancy

GnRH agonists

• Tumor flare

• Gynecomastia

• Hot flashes

• Erectile dysfunction

Degarelix

• Tumor flare

• Gynecomastia

• Hot flashes

• Erectile dysfunction

• Injection site reactions

Radium 223

• Impaired fertility

• Secondary malignancy

Sipuleucel-T

• Chills

Flutamide

• Hepatotoxicity

Bicalutmaide

• Diarrhea

• Hematuria

Nilutamide​

• Decreased visual accommodation

• Interstitial pneumonitis

Apalutamide

• Hypothyroidism

• Hypertension

• Fractures

• Rash

• Leukopenia

Darolutamide

• Neutropenia

• Hypertension

• Fractures

• Rash

Enzalutamide

• Neutropenia

• Hypertension

• Fractures

• Ischemic heart disease

Abiraterone

• Hepatotoxicity

• Hypokalemia