Anti-EGFRs will cause magnesium loss in almost all patients
Almost all cancer patients treated with monoclonal antibodies that target epidermal growth factor receptors (EGFR) will have some degree of hypomagnesaemia, research suggests.
Previous retrospective studies had shown severe magnesium loss (grades
3 and 4 hypomagnesaemia) in a small proportion of patients given anti-EGFR
drugs. Magnesium loss can cause dizziness, weakness, cardiac abnormalities
and generalised convulsions.
Sabine Tejpar, of the University Hospital Gasthuisberg, Leuven, and colleagues
measured the degree of hypomagnesaemia in 98 patients with metastatic
colorectal cancer treated with EGFR-targeting antibodies with or without
combined chemotherapy. All but three (97 per cent) of the patients had
decreased serum magnesium concentrations during treatment compared with
baseline measures (mean serum magnesium slope –0.00157 mmol/L/day,
95 per cent confidence interval –0.00191 to –0.00123) and
this change was lower than that seen in the control group not receiving
antibody treatment (0.00014 mmol/L/day, –0.00026 to 0.00055).
The authors conclude: “Careful monitoring of serum magnesium is
warranted during the duration of treatment because symptoms of hypomagnesaemia
can easily remain unrecognised.” (Lancet Oncology 2007;8:387.)
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