Chemo and Immunorx Side Effects

Nausea & vomiting common (NEJM 2016;374:1356; 375:134 & 177)
Select Adverse Effects from Chemotherapy
Toxicity Common Agents Comments
Cardiotoxicity
( NEJM 2016;375;1457)
Anthracyclines Dose-dependent CMP; ✓ EF pre-Rx
5-FU Spasm → ischemia; CCB may prevent
Trastuzumab CMP, esp w/ anthracycline, ✓ EF pre-Rx
Tyrosine kinase inhib (TKI) QTc prolongation, CMP, angina
Cyclophosphamide Myopericarditis (esp. in BMT)
Cisplatin HypoMg → arrhythmia, ischemia
Pulmonary
( Sem Oncol 2006;33:98)
Busulfan ~8% fibrosis or DAH; if severe → steroids
Bleomycin ~10% IPF; d/c drug, Rx: steroids
TKI (esp. dasatinib) Pleural effusion
Cyclophosphamide Pneumonitis, progressive brosis; Rx: d/c