NCCN Guidelines for Patients
Rectal Cancer, Version 1.2017
Overview of cancer treatments
You may develop an infection, fever, change in voice,
mouth sores, and high blood pressure.
Your hands and feet may become red and have pain.
This is called hand-foot skin reaction. It is important
to remove calluses on hands and feet before starting
Rare but serious side effects of regorafenib include
heart attack, holes in the gut, abnormal passage
between body parts, and severe bleeding. Liver
damage may be severe. Very rarely, brain damage
Ziv-aflibercept works by acting as a decoy. VEGF
thinks ziv-aflibercept is a surface receptor and
attaches to it. Thus, ziv-aflibercept traps VEGF so
it is unable to bind to the real receptor. Hence its
other name is VEGF-trap. By trapping VEGF, growth
signals caused by VEGF within endothelial cells
won’t be started.
Ziv-aflibercept is given by infusion. You’ll receive it
over the course of about 1 hour every two weeks. It
is given with chemotherapy.
While taking ziv-aflibercept, you may have diarrhea,
mouth sores, voice changes, and nose bleeds.
You may have headaches and stomach pain. You
may feel tired. Loss of appetite and weight loss are
common. Tests may show low blood cell counts,
protein in urine, liver inflammation, increased blood
pressure, or kidney damage.
Rare but serious side effects include blood clots,
holes in the gut, abnormal passage between body
parts, and severe bleeding. Infections may be
serious. Very rarely, brain damage occurs.
Cell growth is started by growth signals. EGFR is one
of the surface receptors in rectal cancer cells that
can trigger growth signals. When EGF (
actor) attaches to EGFR, the chemical
pathway that sends growth signals is turned on.
Some people with rectal cancer have abnormal
changes in their gene that controls EGFRs. These
changes cause the cancer cells to have too many
EGFRs. For a small group of people, the EGFRs
may be overactive.
With too many or overactive EGFRs, new cancer
cells form quickly. There are two medicines used
to block the growth signals from EGFRs.
. These medicines don’t work if the cancer
cells have mutations in
Cetuximab treats rectal cancer by attaching to the
ends of EGFRs that are outside of the cell. Thus,
EGF is blocked from attaching and triggering growth
signals. Cetuximab also attracts immune cells that
help to kill the cancer cells.
Cetuximab is given by infusion, usually once a
week or every other week. It may take 2 hours to
receive the first dose. Later doses will take only
1 hour. Cetuximab may be given with or without
Common side effects of cetuximab are skin
problems. These problems include acne-like rash,
dry skin, eye inflammation, and skin infections.
Other common side effects are diarrhea and loss of
appetite. Blood magnesium levels may drop. Rare
but serious side effects include a severe reaction to
the infusion and lung damage.