GI Toxicities from Cancer Therapy

Gastrointestinal toxicities including nausea, vomiting, oral mucositis, diarrhea, and constipation are common side effects of chemotherapy, targeted agents, and immunotherapy in cancer patients. The frequency and severity of these adverse effects vary based on the specific drugs/regimen, frequency, dosage, tumor type, and individual susceptibility. Combination of different cancer drugs and concurrent chemotherapy plus radiation therapy increases the risk and severity of GI toxicity. Many of these complications are life-threatening and require immediate attention and treatment. These toxicities may cause treatment delays, dose adjustment, and/or discontinuation of treatment, as well as a decrease in quality of life. Knowledge of the adverse effects seen with each agent is helpful to properly premedicate patients to prevent toxicities and to act in a timely manner to treat concerning symptoms when they arise. In this chapter, we will discuss GI toxicity of cytotoxic drugs, targeted therapies, and immunotherapies separately.