Side Effects and Monitor

tamoxifen

VTE, hot flashes endometrial cancer, cataracts

aromatase inhibitor

arthralgia, myalgia, bone loss, fracture risk, lipid effects

kadcyla (ado-trastuzumab)

thrombocytopenia, transaminitis, tbili elevation, neuropathy, cardiac monitoring

neratinib

diarrhea → use ppx antidiarrheal

capecitabine

hand-foot syndrome, diarrhea, mucositis

olaparib, talazoparib (PARP I)

anemia, neutropenia, fatigue, nausea, rare MDS/AML

alpelisib

hyperglycemia, rash diarrhea. frequent and early glucose monitoring. can consider ppx nonsedating antihistamine

inavolisib

hyperglycemia, diarrhea, stomatitis, neutropenia

elacestrant

nausea, fatgue, arthtralgia

capivaserib

rash, diarrhea

everolimus

stomatitis → can use dex mouthwash

trastuzumab dexrutecan (enhertu)

ILD/pneumonitis, nausea, myelosuppression

datopotamab dexrucan

severe neutropenia, diarrhea

palbociclib

neutropenia, CBC monitoring

ribociclib

neutropenia, QT prolongation, hepatotoxicity, ECG, electrolytes, CBC, LFT monitoring

abemaciclib

diarrhea, less neutropenia that other CDK4/6 I, VTE, hepatotoxicity

AML defining cytogenesis

t(8;21), inv(16/t(16;16), t(15;17)

Ph+ALL

philadelphia positive; t(9;22)/BCR::ABL1. Hyper-CVAD+imatinib/dasatinib/ponatinib

asparginase

pancreatis, thrombosis, intracranial hemorrhage, hypofigrinogenemia, TG increase, hyperglycemia, hepatotoxicity

blina

CRS, ICANS; CD19

inotuzumab

VOS/SOS; CD22

gemtuzumab

VOD/SOS, hepatotoxicity, infusion reactions, myelosuppression

FLT3 inhibitors

QTc and CYP interactions; quizartinib → major QT considerations

IDH/menin inhibitors

differential syndrome: fever, edema/wt gain, pulmonary infiltrates/hypoxia, hypotension, renal dysfunction

PML::RARA t (15;17)

APL

del(5q)

use lenalidomide in MDS

BTK inhibitor

CML

class SE: afib, bleeding, hypertension, infection

ibrutinib: diarrhea, arthralgia, drug interaction. Most risk for afib. not preferred due to toxicity

acalabrutinib: HA, cytopenia. less afib than ibrutinib

zanubrutinib: neutropenia. more neutropenia but better PFS and safety outcomes compared to ibrutnib

pirtobrutinib: bibcivalent. infection, bleeding, neutropenia

venetoclax

TLS, neutropenia, infection, CYP3A/P-gp interactions

obinutuzumab

infusion reaction, neutropenia, infection, HBV reactivation risk

PI3K inhibitor

immune-mediated colitis, hepatotoxicity, pneumonitis, infection, opportunistic infection concerns