92IN - GI toxicity

Date 27 September 2014
Event ESMO 2014
Session Targeting precision medicine toxicity
Topics Complications/Toxicities of treatment
Supportive measures
Presenter Jervoise Andreyev
Citation Annals of Oncology (2014) 25 (suppl_4): iv33-iv34. 10.1093/annonc/mdu310
Authors J. Andreyev
  • The Gi Unit, Royal Marsden Hospital, - - London/GB




GI symptoms arising as a side effect of cancer treatments are many, cause significant morbidity, impact enormously on quality of life, not infrequently impair the delivery of optimal cancer therapy, are managed erratically, are increasingly common with many new classes of anti-cancer agents and in clinical trials consistently lead to death in up to 5% of patients. The severity of acute toxicity also predisposes to worse long term toxicity with some treatment modalities. GI toxicities rated as extremely debilitating by patients are widely regarded as unimportant by healthcare professionals. Most current treatments for cancer therapy-induced GI toxicity are symptomatic and as a result are surprisingly often ineffective as identical symptoms may arise for many different reasons. There has been little research effort to identify the cause for cancer therapy-induced GI symptoms yet increasing evidence suggests that highly treatable and unpleasant physiological abnormalities induced by cancer therapies for example carbohydrate malabsorption, small bowel bacterial overgrowth, pancreatic insufficiency and bile acid malabsorption are frequent and rarely identified or properly treated. Appropriate multidisciplinary assessment repeated when necessary, much more rational use of supportive drug and targeted nutritional therapies can transform outcomes. The success in controlling cancer-treatment induced nausea and vomiting has not been reproduced for other GI symptoms. Considering the impact of cancer therapy-induced GI toxicity on the patient, relatives, health care professional and healthcare budgets, much could be done immediately and for the future, simple, appropriate multidisciplinary research aimed at meaningful end points has the potential to transform an important but neglected aspect of cancer care.


J. Andreyev: Receipt of honoraria or consultation fees: GE Electric, sanofi aventis.