title: Hypomagnesaemia in patients with metastatic colorectal carcinoma treated with cetuximab.
abstract: OBJECTIVE
  Cetuximab is a chimeric antibody registered for the therapy of advanced colorectal carcinoma. Among the side-effects of cetuximab hypomagnesaemia has been described, but the information is still limited.
  
  
  METHODS
  We have evaluated retrospectively serum magnesium, potassium, calcium, creatinine and albumin in 51 consecutive patients with metastatic colorectal carcinoma treated with cetuximab, mostly combined with irinotecan-based combination chemotherapy.
  
  
  RESULTS
  A significant decrease of serum magnesium, potassium, calcium and corrected serum calcium, creatinine and albumin concentrations was already evident one week after the start of treatment. Hypomagnesaemia of any grade was detected in 56% of evaluable patients, but grade 3 or grade 4 hypomagnesaemia was observed in 6% and 4% of patients, respectively. Grade 1 hypokalemia was detected in 47%, grade 3 in 17% and grade 4 hypokalemia was detected in 6% of the patients. Among evaluable patients grade 1 hypocalcaemia was detected in (36%), grade 2 hypocalcaemia in 42%, grade 3 in 4% and grade 4 in 13% of patients. Baseline hypocalcaemia of grade 1 or higher was associated with significantly inferior survival.
  
  
  CONCLUSIONS
  Asymptomatic hypomagnesaemia, hypokalemia and hypocalcaemia are common in metastatic colorectal carcinoma patients treated with cetuximab. Hypocalcaemia is a predictor of poor prognosis.
authors.affiliation: Department of Oncology, Palacky University Medical School and Teaching Hospital, Olomouc, Czech Republic. bohuslav.melichar@fnol.cz
authors.forename: Bohuslav
authors.initials: B
authors.lastname: Melichar
authors.forename: Pavlína
authors.initials: P
authors.lastname: Králíčková
authors.forename: Radomír
authors.initials: R
authors.lastname: Hyšpler
authors.forename: Hana
authors.initials: H
authors.lastname: Kalábová
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Cerman
authors.forename: Petra
authors.initials: P
authors.lastname: Holečková
authors.forename: Hana
authors.initials: H
authors.lastname: Studentová
authors.forename: Eva
authors.initials: E
authors.lastname: Malířová
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000009:adverse effects*; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood; D002277:Carcinoma / Q000188:drug therapy* / Q000201:enzymology / Q000401:mortality / Q000556:secondary; D000068818:Cetuximab; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000401:mortality / Q000473:pathology; D003404:Creatinine / Q000097:blood; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000378:metabolism; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000139:chemically induced; D007008:Hypokalemia / Q000097:blood / Q000139:chemically induced; D053208:Kaplan-Meier Estimate; D008274:Magnesium / Q000097:blood*; D008297:Male; D008659:Metabolic Diseases / Q000097:blood / Q000139:chemically induced* / Q000401:mortality; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D000075462:Serum Albumin, Human; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: C422455:ALB protein, human; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D015415:Biomarkers; D047428:Protein Kinase Inhibitors; D012709:Serum Albumin; D003404:Creatinine; C512478:EGFR protein, human; D066246:ErbB Receptors; D008274:Magnesium; D000068818:Cetuximab; D011188:Potassium; D002118:Calcium; D000075462:Serum Albumin, Human