title: Targeted therapy-induced diarrhea: A review of the literature.
abstract: OBJECTIVE
  Revision of the literature on targeted therapy-induced diarrhea (TT-ID).
  
  
  RESULTS
  TT-ID is frequent; the mechanisms are mainly secretive, followed by ischemic or autoimmune ones. The duration of TT-ID is protracted over time. Its intensity is of grade G1-G3 but may be fatal in patients with diffuse colitis or on ipilimumab. However, no specific guidelines are available on management of different grades of TT-ID. Preventive measures with antibiotics, probiotics or activated charcoal should be further investigated. Loperamide is the first choice drug followed by octreotide. The role of corticosteroids is controversial.
  
  
  CONCLUSIONS
  Early assessment and management of TT-ID is essential to prevent the worsening of this side-effect, patients' hospitalization and dose reduction or oncological treatment discontinuation. Future research is needed to better understand the pathophysiological mechanisms of TT-ID and it should also be investigated whether a specific pharmacological and/or non pharmachological approach is indicated.
authors.affiliation: Supportive Care in Cancer Unit, Department of Hematology and Pediatric Onco-Hematology, Milano, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Pessi
authors.affiliation: Medical Oncology 1 Unit. Fondazione IRCCS, Istituto Nazionale Tumori di Milano, Milan, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Zilembo
authors.affiliation: Medical Oncology 1 Unit. Fondazione IRCCS, Istituto Nazionale Tumori di Milano, Milan, Italy.
authors.forename: E R
authors.initials: ER
authors.lastname: Haspinger
authors.affiliation: Medical Oncology 1 Unit. Fondazione IRCCS, Istituto Nazionale Tumori di Milano, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Molino
authors.affiliation: Medical Oncology 1 Unit. Fondazione IRCCS, Istituto Nazionale Tumori di Milano, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Di Cosimo
authors.affiliation: Medical Oncology 1 Unit. Fondazione IRCCS, Istituto Nazionale Tumori di Milano, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Garassino
authors.affiliation: Supportive Care in Cancer Unit, Department of Hematology and Pediatric Onco-Hematology, Milano, Italy. Electronic address: carla.ripamonti@istitutotumori.mi.it.
authors.forename: C I
authors.initials: CI
authors.lastname: Ripamonti
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003967:Diarrhea / Q000139:chemically induced*; D006801:Humans
chemical_list: D000970:Antineoplastic Agents
keywords: Assessment; Diarrhea; Incidence; Targeted therapy; Treatment