title: The safety of monoclonal antibodies for treatment of colorectal cancer.
abstract: BACKGROUND
  Monoclonal antibodies such as bevacizumab, ramucirumab, cetuximab and panitumumab play an important role in the treatment of metastatic colorectal cancer (mCRC). With the introduction of these drugs considerable improvements in both progression-free survival (PFS) and overall survival (OS) were achieved. However these antibodies are associated with a unique side effect profile.
  
  
  METHODS
  This review provides an overview about drug efficacy of bevacizumab, cetuximab, panitumumab and ramucirumab in the treatment algorithm of mCRC. Additionally, we discuss the most common toxicites of these monoclonal antibodies.
  
  
  CONCLUSIONS
  The most common toxicities associated with the VEGF-A directed antibody bevacizumab are hypertension, proteinuria, thromboembolism, bleeding, gastrointestinal perforation and prolonged wound healing. Similarly, the rate of hypertension and proteinuria is increased during treatment with the VEGFR2 antibody ramucirumab. On the other hand the most frequent side effects of EGFR targeted antibodies are skin rash, hypersensitivity reactions and hypomagnesemia. Due to the murine portions of cetuximab the incidence of infusion reactions is more frequent compared to panitumumab which is a pure human monoclonal antibody.
authors.affiliation: a Division of Medical Oncology, Norris Comprehensive Cancer Center , Keck School of Medicine, University of Southern California , Los Angeles , CA , USA.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Berger
authors.affiliation: a Division of Medical Oncology, Norris Comprehensive Cancer Center , Keck School of Medicine, University of Southern California , Los Angeles , CA , USA.|b Department of Preventive Medicine, Norris Comprehensive Cancer Center , Keck School of Medicine, University of Southern California , Los Angeles , CA , USA.
authors.forename: Heinz-Josef
authors.initials: HJ
authors.lastname: Lenz
mesh_terms: D000465:Algorithms; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018572:Disease-Free Survival; D006801:Humans; D009362:Neoplasm Metastasis; D015996:Survival Rate
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents
keywords: Colorectal cancer; bevacizumab; cetuximab; drug safety; monoclonal antibodies; panitumumab; ramucirumab