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The article presents questions and answers related to oncology nursing. The first question is about the best strategy for the management of acneiform rashes resulting from gefitinib therapy. The second and final question is about the clinical applications of magnetic resonance imaging in patients with multiple myeloma.

The article discusses the clinical management of epidermal growth-factor receptor inhibitors (EGFRIs) dermatologic toxicities related to nursing. Nursing diagnosis is a clinical judgment about individual, family or community responses to actual health problems. The potential for infection is stated to be high in cases where EGFRIs are combined with chemotherapy. Nurses are suggested to work towards proper patient education about rashes caused in the therapy.

Numerous receptor tyrosine kinases, including vascular endothelial growth factor receptor (VEGFR), epidermal growth factor (EGFR), and platelet-derived growth factor receptor (PDGFR), have been implicated in the pathogenesis of solid and nonsolid tumors such as chronic myelogenous leukemia (CML), acute myeloid leukemia (AML), hereditary endocrine tumors, and gastrointestinal stromal tumor (GIST). Multikinase inhibitors, a new class of targeted compounds, have demonstrated their activity in various cancers (e.g., imatinib in GIST/CML). Targeted therapeutics are designed to increase efficacy and minimize adverse events (AEs) by inhibiting certain proteins with high specificity. Several MKIs are currently under investigation in clinical trials, including AMG 706, an oral MKI with antiangiogenesis and direct antitumor activity. AMG 706 potently inhibits VEGFR, PDGFR, and Kit in preclinical models. A broad phase I trial in subjects with advanced solid tumors has completed, and additional phase 1b and phase 2 mono therapy and combination therapy trials are ongoing in imatinib-resistant GIST, thyroid cancer, breast cancer, NSCLC, colorectal cancer, and others. To familiarize oncology nurses with the mechanism of action (MOA) of MKIs, the most common AEs seen with AMG 706 and strategies for patient care. We explored the toxicities and pharmacokinetics of AMG 706 in 71 patients with solid tumors treated in a dose-escalating phase I study. AEs were manageable and most commonly included hypertension (34%), fatigue (37%), headache (24%), nausea (18%), vomiting (11%), and diarrhea (27%). The AE requiring most attention with AMG 706 monotherapy is hypertension, which may be related to VEGF inhibition. Nurses need to pay special attention to management of hypertension. Patient education is also crucial. Antihypertensive medications are often sufficient, and in cases of uncontrolled hypertension, a dose reduction and/or consultation with a cardiologist are suggested. Importantly, when MKIs are withheld or discontinued, blood pressures usually return to baseline. Other predictable and manageable AEs of AMG 706 include diarrhea and headache. In contrast, some MKIs lead to drug accumulation and/or other toxicities that may require interrupted dosing schedules. MKIs such as AMG 706 are increasingly used for cancer treatment. It is critical for oncology nurses to familiarize themselves with the MOA of MKIs and their potential toxicities. [ABSTRACT FROM AUTHOR]