Patients – Drugs & Side Effects

Bevacizumab (Avastin)

Bevacizumab is used with chemotherapy to treat cancer of the colon (large intestine) or rectum that has spread to other parts of the body. Bevacizumab is in a class of medications called antiangiogenic agents. It works by stopping the formation of blood vessels that bring oxygen and nutrients to tumors. This may slow the growth and spread of tumors.

Side Effects of Bevacizumab

Avastin® (Bevacizumab) is a biolgic cancer drug that binds two growth factors in your body to prevent new blood vessels from forming. Some of the major side effects are vascular, including high blood pressure, nose bleeds, and rarely stroke and heart attack. Bowel perforation is also a possible serious side effect.

Anti-VEGF Therapies

Bevacizumab is an anti-VEGF treatment (sometimes called Avastin) given to some patients with advanced colon cancer. It helps block the formation of new blood vessels making it more challenging for cancer cells to migrate throughout the body.

Capecitabine (Xeloda)

Capecitabine is used to treat colon or rectal cancer that has gotten worse or spread to other parts of the body. It is also used to prevent colon cancer from spreading in people who have had surgery to remove the tumor. Capecitabine is in a class of medications called antimetabolites. It works by stopping or slowing the growth of cancer cells.

Dosing of Xeloda

Dosing of Xeloda can have variations that may be more beneficial to different patients. It’s important to consider the right approach for you with your medical team.

Side Effects of Xeloda

Xeloda is the pill version of 5-FU and you take it twice a day. A single dose has no side effects, but over time, side effects like hand and foot peeling, diarrhea, fatigue, sensitivity to sun and on rare occasions heart damage can be present.

Cetuximab

Cetuximab is used alone or in combination with other medications to treat a certain type of cancer of the colon or rectum that has spread to other parts of the body. Cetuximab is in a class of medications called monoclonal antibodies. It works by slowing or stopping the growth of cancer cells.


Molecular Profiling with Cetuximab or Panitumumab

Dr. John Marshall discusses the treatment and potential side effects of Cetuximab and Panitumumab, two chemotherapy drugs used to treat the small subset of colon cancer patients with tumors of the left side of the colon. Cetuximab and Panitumumab may cause adverse skin reactions, however these can be reduced with a regimen of sun avoidance and sunblock, skin moisturizers, hydrocortisone cream, and in certain cases an oral antibiotic may be recommended.

Fluorouracil Injection (5-FU)

Fluorouracil is generally used in combination with other medications to treat colon cancer or rectal cancer that has gotten worse or spread to other parts of the body. Fluorouracil is also used to treat cancer of the pancreas and stomach cancer. Fluorouracil is in a class of medications called antimetabolites. It works by slowing or stopping the growth of cancer cells in your body.

5-FU Infusion

5-FU is a chemotherapy drug that is administered in two ways; either through a mediport which can be done at home or you can get 5-FU with bolus using an IV. Bolus is less common and may have additional side effects.

FOLFIRINOX

A regimen consisting of leucovorin calcium, fluorouracil, irinotecan hydrochloride, and oxaliplatin used for the treatment of pancreatic cancer that has metastasized.

Chemotherapy for Pancreatic Cancer: FOLFIRINOX

Dr. Michael Pishvaian discusses FOLFIRINOX, a chemotherapy approach to treating Pancreatic Cancer. It has some common side effects, such as nausea, hair loss, and sometimes vomiting. He helps you understand what symptoms you might encounter during the treatment.

Chemotherapy for Pancreatic Cancer: FOLFIRINOX details

FOLFIRINOX is a combination of three chemotherapy drugs used in the treatment of pancreatic cancer patients, and is given in the form of an IV 5-FU pump. Patients are often prescribed multiple powerful anti-nausea medications before treatment to make FOLFIRINOX tolerable.

FOLFOX

Chemotherapy is often given as a combination of drugs. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways. FOLFOX is used to treat colorectal cancer.

FOL = Leucovorin Calcium (Folinic Acid), F = Fluorouracil, OX = Oxaliplatin

FOLFOX / XELOX Side Effects

Front line therapy for respected colon cancer or colon cancer that has spread to other parts of the body is often treated with FOLFOX or CAPOX. The 5-FU (a fluoropyrimidine drug) often has various side effects, such as nausea, vomiting, diarrhea, and low blood counts. Oxaliplatin can cause cold hypersensitivity, neuropathy, extravasation, and allergic reactions. It is advised to limit cumulative exposure to oxaliplatin.

Gemcitabine + Abraxane

A combination of chemotherapy drugs, ABRAXANE®, and gemcitabine to improve overall survival in patients with untreated, metastatic pancreatic adenocarcinoma. It works by slowing or stopping the growth of cancer cells in your body.

Chemotherapy for Pancreatic Cancer: Gemcitabine + Abraxane

Gemcitabine and Abraxane is a well-tolerated chemotherapy regimen for pancreatic cancer patients. Retrospective research has shown that negative symptoms can be reduced without reduced effectiveness when the drugs are given every two weeks instead of weekly.

Irinotecan Hydrochloride (Camptosar)

Irinotecan is used alone or in combination with other medications to treat colon or rectal cancer (cancer that begins in the large intestine). Irinotecan is in a class of antineoplastic medications called topoisomerase I inhibitors. It works by stopping the growth of cancer cells.

Side Effects of Irinotecan

Irinotecan (Camptosar) is a drug commonly used to treat GI Cancers that is administered by IV (often a mediport). This drug can cause some hair loss, tiredness, lower blood counts, and possibly diarrhea.

Oxaliplatin (Eloxatin)

Oxaliplatin is used with other medications to treat advanced colon or rectal cancer (cancer that begins in the large intestine). Oxaliplatin is also used with other medications to prevent colon cancer from spreading in people who have had surgery to remove the tumor. Oxaliplatin is in a class of medications called platinum-containing antineoplastic agents. It works by killing cancer cells.

Side Effects of Oxaliplatin

Oxaliplatin is a common chemotherapy drug often administered via a mediport. Side effects include nausea, possible lower blood counts, and sensitivity to cold things (touch and drinking). Over many cycles of the medicine, you may have nerve sensitivity.

Panitumumab

Panitumumab is used to treat a type of cancer of the colon or rectum that has spread to other areas of the body either during or after treatment with other chemotherapy drugs. Panitumumab is in a class of medications called monoclonal antibodies. It works by slowing or stopping the growth of cancer cells.

Molecular Profiling with Cetuximab or Panitumumab

Dr. John Marshall discusses the treatment and potential side effects of Cetuximab and Panitumumab, two chemotherapy drugs used to treat the small subset of colon cancer patients with tumors of the left side of the colon. Cetuximab and Panitumumab may cause adverse skin reactions, however these can be reduced with a regimen of sun avoidance and sunblock, skin moisturizers, hydrocortisone cream, and in certain cases an oral antibiotic may be recommended.

Pembrolizumab

Pembrolizumab injection is in a class of medications called monoclonal antibodies. It works by helping your immune system to slow or stop the growth of cancer cells. It is used to treat certain types of gastric or esophageal cancer that has returned or that has spread to other parts of the body during or after 2 or more chemotherapy treatments.

Pembrolizumab

Pembrolizumab is a newer immunotherapy drug used for the treatment of different cancers, most notably lung cancer, colon cancer, skin cancer, and cancer of the endocrine glands. By blocking a specific immune receptor, Pembrolizumab causes an increased activity of the immune system, allowing the body to better destroy cancer cells. Due to an increase in immune function, symptoms similar to an autoimmune disease may arise.

Ramucirumab

Ramucirumab injection is used alone and in combination with another chemotherapy medication to treat stomach or esophageal cancers when these conditions do not improve after treatment with other medications. Ramucirumab is in a class of medications called monoclonal antibodies. It works by stopping the growth of cancer cells.

Ramucirumab

Ramucirumab, a well-tolerated anti-angiogenesis drug with few side effects, and is often used during second-line treatment of gastric and esophageal cancers. Anti-angiogenesis drugs, like Ramucirumab, are prescribed to halt tumor growth and improve overall patient progress through prevention of new blood vessel formation.

Regorafenib (STIVARGA)

Regorafenib is used to treat colon and rectal cancer that has spread to other parts of the body in people who have not been treated successfully with certain other medications. It is also used to treat gastrointestinal stromal tumors (GIST) in people who were not treated successfully with certain other medications. Regorafenib is also used to treat hepatocellular carcinoma (HCC) in people who were previously treated with sorafenib (Nexafar). Regorafenib is in a class of medications called kinase inhibitors. It works by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps to slow or stop the spread of cancer cells.

Dosing of STIVARGA

Recently, doctors are considering a new dosing strategy for STIVARGA® (Regorafenib). The ReDOS (Bekaii-Saab) Trial suggests starting with a lower dose and appears to be having a positive impact for some patients.

Side Effects of STIVARGA

STIVARGA (Regorafenib) can have some serious side effects. Minimize the side effects by taking pills after a meal, using Urea cream, having regular blood tests, and meeting with your team regularly.

Trifluridine & Tipiracil (Lonsurf)

The combination of trifluridine and tipiracil is used to treat colon or rectal cancer that has spread to other parts of the body in people who have already been treated with other chemotherapy medications or cannot receive these chemotherapy medications. Trifluridine is in a class of medications called thymidine-based nucleoside analogues. It works by stopping the growth of cancer cells. Tipiracil is in a class of medications called thymidine phosphorylase inhibitor. It works by slowing the breakdown of trifluridine by the body.

Dosing and Side Effects of Lonsurf

Lonsurf (trifluridine and tipiracil) is a drug treatment option for 3rd line Metastatic Colon Cancer. This is pill therapy often used when the disease progresses after chemotherapy and other treatments. There are notable side effects such as low white blood cell count. It can also cause nasuea, vomiting, diarrhea, decreased appetite, and abdominal pain.

Disclaimer: These videos are produced and broadcast by the Ruesch Center for the Cure of GI Cancers solely for educational purposes. The information included in it is not intended to replace the advice and recommendations of your healthcare team. Medicine is an ever-changing field; the dose and method of administration for any administered drug should be confirmed before use. These videos are not intended to recommend any measures, techniques, procedures or products, or give advice, and is not a substitute for medical training or your men clinical judgment as a healthcare professional.