Strategies to mitigate the toxicity of cancer therapeutics.

Abstract

Cancer therapeutics are dynamically evolving, and include traditional chemotherapy and hormone therapy, as well as more recently developed treatment modalities, such as tyrosine kinase inhibitors, monoclonal antibodies and the revolutionary approach based on immune checkpoint inhibition. These regimens are unfortunately not free of adverse events, and patients with cancer are a susceptible population experiencing a myriad of disease and treatment toxicities combined. In this review, we present the latest overview of the management of the most common systemic cancer treatment symptoms and the science of symptom management supporting these strategies. We discuss cancer-related cognitive impairment, ocular toxicity, ototoxicity, oral mucosal toxicities, gastrointestinal toxicities, renal toxicity, aromatase inhibitor-induced musculoskeletal symptoms, chemotherapy-induced peripheral neuropathy, and immunotherapy-induced autoimmunity derived from systemic therapies for cancer. In summary, we review the future directions and ideal goals of symptom science research in order to benefit patients utilizing a comprehensive individualized approach.