Does Pemetinib (Dabotan), a targeted drug, have serious side effects? Analysis of drug risks for patients

Pemigatinib is an oral targeted drug specifically targeting FGFR2 fusion or rearrangement mutant cholangiocarcinoma. Its side effects are generally controllable, but some adverse reactions are specific and require patients to be closely monitored during medication. Because this drug works by inhibiting the fibroblast growth factor receptor (FGFR) signaling pathway, many side effects are related to the physiological function of this pathway and are expected risks. Overall, pemetinib is better tolerated than traditional chemotherapy, but it is a long-term drug, so its effects on the eyes, metabolism, electrolytes and skin require special attention.

First of all, the most typical adverse reaction is hyperphosphatemia, which is the most common metabolic side effect after the FGFR pathway is inhibited. Because FGFR plays a key role in regulating phosphorus excretion, serum phosphorus may rise rapidly after the drug takes effect. Mild elevations can usually be controlled with dietary restrictions (such as reducing dairy, nuts, soy products, etc.) and oral phosphorus binders. However, if it continues to rise or the value is too high, it may lead to risks such as soft tissue calcification and kidney damage, requiring doctors to adjust the dose or suspend treatment. Patients need to regularly monitor blood phosphate before, during and after medication to ensure that treatment is maintained within a safe range.

The second category of concern is ocular side effects, including central serous retinopathy (CSR) or changes in the retinal pigment epithelium. Although most cases are mild to moderate, reversible changes, severe cases may affect vision. Therefore, the instructions recommend that patients undergo an eye examination before taking the drug and then re-examine every 2–3 months. If the patient experiences blurred vision, black shadows, flashing lights, etc., he or she should report to the doctor immediately. If necessary, pemetinib should be suspended and the patient should undergo ophthalmological evaluation. Prompt intervention is usually reversible, but delay may lead to irreversible damage.

In addition, pemetinib may also cause common adverse reactions of targeted drugs such as hair loss, stomatitis, fatigue, diarrhea, rash, and nail changes, most of which are mild to moderate and manageable. Some patients may have elevated liver enzymes or electrolyte disorders, so liver function, electrolytes and blood routine tests need to be checked regularly. Because its mechanism of action does not directly destroy normal cells, it has fewer severe toxicities such as nausea, vomiting, and bone marrow suppression than chemotherapy, but individual tolerance still needs to be carefully monitored. In general, although the side effects of pemetinib are not "very serious", they do have specific risks. Patients must follow up strictly according to the doctor's instructions and deal with abnormalities in a timely manner so as to maximize the therapeutic effect while ensuring safety.

Keyword tag:

Pemetinib, dalbertam,FGFRinhibitors, cholangiocarcinoma, side effects, hyperphosphatemia, ocular side effects, adverse reactions, medication risks, targeted therapy

Reference materials:https://pmc.ncbi.nlm.nih.gov/articles/PMC9991984/