Risk Factors of Cetuximab-Induced Hypomagnesemia and the Effect of Magnesium Prophylaxis in Patients with Head and Neck Cancer: A Retrospective Study
-
- Matsukane Ryosuke
- Department of Pharmacy, Kyushu University Hospital
-
- Isshiki Risa
- Department of Clinical Pharmacology and Biopharmaceutics, Graduated School of Pharmaceutical Sciences, Kyushu University
-
- Suetsugu Kimitaka
- Department of Pharmacy, Kyushu University Hospital
-
- Minami Haruna
- Department of Pharmacy, Kyushu University Hospital
-
- Hata Kojiro
- Department of Pharmacy, Kyushu University Hospital
-
- Matsuo Mioko
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University
-
- Egashira Nobuaki
- Department of Pharmacy, Kyushu University Hospital Department of Clinical Pharmacology and Biopharmaceutics, Graduated School of Pharmaceutical Sciences, Kyushu University
-
- Hirota Takeshi
- Department of Pharmacy, Kyushu University Hospital Department of Clinical Pharmacology and Biopharmaceutics, Graduated School of Pharmaceutical Sciences, Kyushu University
-
- Nakagawa Takashi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University
-
- Ieiri Ichiro
- Department of Pharmacy, Kyushu University Hospital Department of Clinical Pharmacology and Biopharmaceutics, Graduated School of Pharmaceutical Sciences, Kyushu University
説明
<p>Hypomagnesemia is a characteristic adverse event of cetuximab in patients with head and neck cancer (HNC). However, there is limited information about its prevalence, risk factors, and preventive strategies. This study aimed to investigate the risk factors of hypomagnesemia and examine the preventive effects of prophylactic magnesium (Mg) administration. We initially investigated HNC patients treated with cetuximab between 2013 and 2019. Our institute started prophylactic Mg treatment (20-mEq Mg sulfate administration before cetuximab) in practice during this period. We retrospectively assess the preventive efficacy by comparing patients before and after its implementation. In total, 109 patients were included. In 60 patients without prophylaxis, all-grade and grade ≥2 hypomagnesemia at 3 months occurred in 61.7 and 15.0% of patients. The incidence of hypomagnesemia was not affected by regimens and concomitant medications. In 49 patients treated with prophylactic Mg treatment, there was no significant decrease in the cumulative incidence of hypomagnesemia. However, the preventive Mg treatment eliminated the need for additional Mg repletion to maintain Mg levels in patients treated with paclitaxel + cetuximab. A risk factor in patients without prophylaxis was a low Mg level at pre-treatment (≤2.0 mg/dL) (odds ratio: 6.03, 95% confidence interval: 1.78–20.4, p = 0.004), whereas that in patients with prophylaxis was the number of cetuximab doses (≥10) (odds ratio: 5.50, 95% confidence interval: 1.52–19.87, p = 0.009). In conclusion, a low pre-treatment Mg level was the only risk factor that could be avoided by prophylactic Mg administration. This preventive intervention is recommended for managing cetuximab-induced hypomagnesemia.</p>
収録刊行物
-
- Ｂｉｏｌｏｇｉｃａｌ ＆ Ｐｈａｒｍａｃｅｕｔｉｃａｌ Ｂｕｌｌｅｔｉｎ
-
Ｂｉｏｌｏｇｉｃａｌ ＆ Ｐｈａｒｍａｃｅｕｔｉｃａｌ Ｂｕｌｌｅｔｉｎ 47 (3), 732-738, 2024-03-29
公益社団法人 日本薬学会