Panitumumab-related hypomagnesemia in patients with colorectal cancer

Haiying Cheng, David Gammon, Traci M. Dutton, Bilal Piperdi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: Hypomagnesemia is an adverse reaction associated with epidermal growth factor receptor (EGFR)-targeting monoclonal antibodies. Of the 2 EGFR antibodies approved by the US Food and Drug Administration-cetuximab and panitumumab-cetuximab-induced hypomagnesemia has been extensively characterized but panitumumab-induced hypomagnesemia has not. Methods: In this retrospective study, the clinical course of hypomagnesemia is described in three 64- to 68-year-old men who received panitumumab monotherapy or panitumumab-plus- irinotecan therapy for colorectal cancer for 8 to 21 weeks. Results: The onset of hypomagnesemia was variable, ranging from 1 week to 10 weeks following the initiation of panitumumab. Magnesium levels did not normalize until 4 to 8 weeks after discontinuation of the agent. Of the patients in the study, 2 had new onset of grade 3 hypomagnesemia 1 to 3 weeks after panitumumab was discontinued. Management was magnesium sulfate 2 g infusion weekly and magnesium oxide 1,200 mg oral repletion daily. With severe hypomagnesemia (grade 3 and higher) or significant diarrhea (grade 3 and higher), a daily infusion of magnesium sulfate 2 or 4 g was administered. Conclusion: When administering panitumumab therapy, magnesium levels should be monitored from the initiation of the agent to at least 8 weeks following cessation. Hypomagnesemia usually can be managed with magnesium sulfate 2 to 4 g infusion weekly and magnesium oxide 1,200 mg oral repletion daily. Future research is warranted to identify simple and efficient strategies for monitoring and treating EGFR blockade with monoclonal antibody-associated hypomagnesemia.

Original languageEnglish (US)
Pages (from-to)234-238
Number of pages5
JournalHospital Pharmacy
Volume44
Issue number3
StatePublished - Mar 2009
Externally publishedYes

Fingerprint

Colorectal Neoplasms
Magnesium Sulfate
Magnesium Oxide
Epidermal Growth Factor Receptor
irinotecan
Magnesium
Monoclonal Antibodies
United States Food and Drug Administration
panitumumab
Diarrhea
Retrospective Studies
Antibodies
Monitoring
Therapeutics

Keywords

  • Colorectal cancer
  • EGFR
  • Hypomagnesemia
  • Panitumumab

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Pharmacy

Cite this

Panitumumab-related hypomagnesemia in patients with colorectal cancer. / Cheng, Haiying; Gammon, David; Dutton, Traci M.; Piperdi, Bilal.

In: Hospital Pharmacy, Vol. 44, No. 3, 03.2009, p. 234-238.

Research output: Contribution to journalArticle

Cheng, Haiying ; Gammon, David ; Dutton, Traci M. ; Piperdi, Bilal. / Panitumumab-related hypomagnesemia in patients with colorectal cancer. In: Hospital Pharmacy. 2009 ; Vol. 44, No. 3. pp. 234-238.
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