title: An oncology nurses' guide to new targeted agents for metastatic colorectal cancer.
abstract: BACKGROUND
  Colorectal cancer (CRC) that has metastasized before being discovered, or reoccurs following surgery, remains a major treatment challenge. Trials have established the usefulness of antiangiogenic agents and new regimens in prolonging survival in patients with advanced disease. In the United States, the antiangiogenic agents approved for treating metastatic CRC often are combined with traditional chemotherapeutic agents and include bevacizumab (Avastin®), ziv-aflibercept (Zaltrap®), and regorafenib (Stivarga®).
  
  
  OBJECTIVE
  This article reviews factors that guide the development of a nursing plan for monitoring and managing patients who are receiving antiangiogenic therapies.
  
  
  METHODS
  Regorafenib and ziv-aflibercept, two newer agents that nurses and other healthcare professionals may have had less experience with, were reviewed.
  
  
  RESULTS
  The key to maximizing the potential benefit of these agents is understanding where these new therapies fit in the overall scheme of treatment options and how to help patients tolerate treatment.
authors.affiliation: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore, MD.
authors.forename: Keith
authors.initials: K
authors.lastname: McIntyre
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000451:nursing* / Q000473:pathology; D006801:Humans; D009362:Neoplasm Metastasis; D010347:Patient Care Planning; D010353:Patient Education as Topic; D010671:Phenylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D011725:Pyridines / Q000009:adverse effects / Q000627:therapeutic use*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D020533:Angiogenesis Inhibitors; D010671:Phenylurea Compounds; D011725:Pyridines; D011993:Recombinant Fusion Proteins; C533178:aflibercept; C559147:regorafenib; D040262:Receptors, Vascular Endothelial Growth Factor
keywords: adverse effects; colorectal cancer; hand-foot syndrome; nurses; regorafenib; ziv-aflibercept