title: Gastrointestinal toxicities from targeted therapies: measurement, duration and impact.
abstract: OBJECTIVE
  Gastrointestinal toxicities deriving from targeted therapies are main issues in the oncologic setting, as they can negatively impair quality of life, reducing patient's adherence to treatment and dose intensity, so ultimately possibly affecting outcome. We reviewed some methodological questions linked to the assessment of this kind of toxicity, in terms of way of measurement, duration of the assessed toxicity and impact on the global treatment program.
  
  
  RESULTS
  The scale of toxicity assessment may influence the evaluation itself; reporting the adverse events by the physician is generally less accurate than by the patient, and these two modalities should be integrated in the analysis of gastrointestinal toxicities by targeted treatment. Moreover, the duration of the symptoms and the attention to the lower grade toxicities estimation are generally underreported in clinical trials. The factors that may affect treatment's adherence by the patient are discussed, as they are strictly linked to the appearance and intensity of gastrointestinal toxicities.
  
  
  CONCLUSIONS
  Methodological issues should be considered in designing new trials with targeted therapies and evaluating the way of assessment of adverse events, mainly gastrointestinal.
authors: aDepartment of Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano bPolo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Rome, Italy.
authors: Paolo
authors: P
authors: Bossi
authors: Maurizio
authors: M
authors: Lucchesi
authors: Andrea
authors: A
authors: Antonuzzo
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000379:methods / Q000592:standards; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D058990:Molecular Targeted Therapy / Q000009:adverse effects; D052016:Mucositis / Q000139:chemically induced / Q000503:physiopathology; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D063868:Patient Outcome Assessment; D012107:Research Design / Q000592:standards*; D057566:Self Report; D012720:Severity of Illness Index; D013280:Stomatitis / Q000139:chemically induced / Q000503:physiopathology; D058570:TOR Serine-Threonine Kinases / Q000009:adverse effects / Q000037:antagonists & inhibitors / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases