Cetuximab Therapy and Symptomatic Hypomagnesemia

We report that patients treated with cetuximab, a monoclonal antibody against the epithelial growth factor receptor (EGFR), occasionally develop a magnesium wasting syndrome with inappropriate urinary excretion. We first observed this phenomenon in a 34-year-old male patient with metastatic colorect...

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Bibliographic Details
Published in:JNCI : Journal of the National Cancer Institute 2005-08, Vol.97 (16), p.1221-1224
Main Authors: Schrag, Deborah, Chung, Ki Young, Flombaum, Carlos, Saltz, Leonard
Format: Article
Language:English
Subjects:
Adult
Antibodies, Monoclonal - administration & dosage
Antibodies, Monoclonal - adverse effects
Antibodies, Monoclonal, Humanized
Antineoplastic Agents - administration & dosage
Antineoplastic Agents - adverse effects
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Biological and medical sciences
Camptothecin - adverse effects
Camptothecin - analogs & derivatives
Cetuximab
Colorectal cancer
Colorectal Neoplasms - blood
Colorectal Neoplasms - drug therapy
Colorectal Neoplasms - metabolism
Drug therapy
Drug toxicity and drugs side effects treatment
Fatigue - etiology
Humans
Hypocalcemia - chemically induced
Hypocalcemia - complications
Immunoglobulins
Incidence
Magnesium
Magnesium - blood
Magnesium Deficiency - chemically induced
Magnesium Deficiency - complications
Male
Medical sciences
Miscellaneous (drug allergy, mutagens, teratogens...)
Pharmacology. Drug treatments
Receptor, Epidermal Growth Factor - antagonists & inhibitors
Severity of Illness Index
Side effects
Tumors
Urine
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Description
Summary:We report that patients treated with cetuximab, a monoclonal antibody against the epithelial growth factor receptor (EGFR), occasionally develop a magnesium wasting syndrome with inappropriate urinary excretion. We first observed this phenomenon in a 34-year-old male patient with metastatic colorectal cancer who developed profound fatigue and symptomatic hypocalcemia and hypomagnesemia while on cetuximab plus irinotecan therapy. Other medications with the potential to cause magnesium wasting had not been administered. Intravenous magnesium supplementation was required for the duration of cetuximab therapy, but electrolyte abnormalities resolved after discontinuation of treatment. This case prompted review of serum chemistry reports for a consecutive case series of 154 colorectal cancer patients treated with cetuximab. Thirty-four patients (22%) had at least one serum magnesium measurement during cetuximab treatment, and six had grade 3 (
ISSN:0027-8874
1460-2105
DOI:10.1093/jnci/dji242