Common side effects of Erlotinib (Loret) and how to reduce their effects

Erlotinib is a classic epidermal growth factor receptor inhibitor and is widely used in the treatment of tumors such as non-small cell lung cancer. Because its targets are also related to normal skin, digestive tract mucosa and other tissues, some characteristic side effects are more likely to occur during clinical use. Most of these adverse reactions are related to drug mechanisms and are not equivalent to "drug intolerance" or "treatment failure." Correct understanding and management are particularly important for patients to standardize their long-term medication use.

Skin-related reactions are the most common type of adverse reactions of erlotinib, among which acne-like rash is the most representative, often appearing in areas with a large distribution of sebaceous glands such as the face, scalp, chest and back, and usually appears within 1~3 weeks after treatment. Dry skin, itching, scaling, and paronychia are also common. Although the appearance of rash may affect quality of life, clinical experience shows that the occurrence of skin reactions is often related to the effectiveness of the drug and does not mean that the drug needs to be stopped immediately. Most skin side effects can be controlled through gentle cleansing, increased moisturizing, sun protection, and the use of topical or oral medications as directed by your doctor.

Gastrointestinal reactions are also a focus of attention during the use of erlotinib, among which diarrhea is the most common, and some patients may also experience loss of appetite, nausea or mild abdominal pain. Diarrhea is mostly mild to moderate and is related to the inhibition of intestinal epithelial cellsEGFR. For mild diarrhea, paying attention to replenishing water and electrolytes and adjusting the diet structure can usually alleviate it; if the diarrhea is frequent or continues to worsen, antidiarrheal drugs should be used under the guidance of a doctor in a timely manner. If necessary, it is necessary to evaluate whether the drug needs to be temporarily stopped or the dosage is adjusted to prevent dehydration and loss of physical strength.

Oral mucosa and eye discomfort are also problems that some patients may encounter during long-term medication, such as oral ulcers, dry mouth, conjunctival irritation, or dry eyes. Such adverse reactions are usually mild, but if care is ignored, they may affect eating and daily life. It is recommended that patients maintain good oral hygiene, avoid spicy and irritating foods, and use mild mouthwash when necessary; when eye discomfort occurs, they should avoid using their eyes for a long time and use artificial tears and other symptomatic treatments under the advice of a doctor.

In terms of laboratory indicators, erlotinib can occasionally cause an increase in liver function indicators, manifested as an increase in transaminase, most of which are mild and reversible changes. Clinical risk management is usually carried out through regular monitoring of liver function. If obvious abnormalities occur, the doctor will adjust the dose or temporarily stop the medication according to the specific situation. For patients with pre-existing liver disease or who require long-term combined medication, the frequency of monitoring should be strengthened to ensure medication safety.

The key to reducing the adverse effects of erlotinib lies in standardized medication and early intervention. Patients should strictly follow the doctor's instructions to take the medication on an empty stomach, avoid taking it at the same time with food or drugs that may affect drug absorption, and avoid increasing or decreasing the dosage on their own. Once adverse reactions occur, you should communicate with your doctor as soon as possible instead of stopping the medication on your own. Through individualized dose adjustment, symptomatic supportive treatment, and continuous follow-up, most patients can take the drug long-term as tolerated.

Overall, the side effects of erlotinib are relatively regular and manageable. As long as patients are fully aware of common adverse reactions and systematically manage them under professional guidance, the vast majority of side effects will not become a major obstacle to treatment. Reasonable control of adverse reactions will not only help improve the quality of life, but also help patients adhere to treatment, thereby more fully obtaining the long-term clinical benefits of targeted therapy.

Keyword tags: erlotinib, side effects, rash, diarrhea, EGFR inhibitors, non-small cell lung cancer, skin care, gastrointestinal management, dose adjustment, liver function monitoring.

Reference:https://www.cancer.gov/about-cancer/treatment/drugs/erlotinib