Incidence and Risk Factors of Hypomagnesemia in Head and Neck Cancer Patients Treated with Cetuximab.
BACKGROUND
Hypomagnesemia is a common adverse event during cetuximab (Cmab) treatment. However, few reports have investigated the incidence and risk factors of hypomagnesemia in head and neck cancer patients treated with Cmab.


METHODS
We retrospectively reviewed 131 head and neck cancer patients who received Cmab-containing therapy. Main eligibility criteria were ≥3 Cmab administrations, no prior EGFR-directed therapy, and no prophylactic Mg supplementation.


RESULTS
Median baseline serum Mg level and number of Cmab administrations were 2.2 mg/dl and 8, respectively. Overall incidence of hypomagnesemia was 50.4% (grade 1, 46.6%; grade 2, 3.1%; grade 3, 0%; and grade 4, 0.8%) and differed between patients treated with palliative chemotherapy and bioradiation (Cmab and radiation) (63 versus 24%; P < 0.01). Independent risk factors were low baseline serum Mg [odds ratio (OR) 161.988, 95% confidence interval (CI) 9.436-2780.895], ≥7 Cmab administrations (OR 3.56, 95% CI 1.16-13.98), and concurrent administration of platinum (cisplatin; OR 23.695, 95% CI 5.219-107.574, carboplatin; OR 5.487, 95% CI 1.831-16.439). Respective incidence of hypomagnesemia in patients in high- (concurrent platinum and ≥7 Cmab administrations) and low-risk (no concurrent platinum and <7 Cmab administrations) groups was 66.0 and 6.6% (P < 0.001, OR 28.0).


CONCLUSIONS
Cmab is associated with a significant risk of hypomagnesemia in patients with head and neck cancer with longer term administration and concurrent platinum therapy. High-risk patients should be treated with particular care.
Department of Head and Neck Medical Oncology, National Cancer Center Hospital East , Kashiwa , Japan.
Tomohiro
T
Enokida
Division of Pharmacy, National Cancer Center Hospital East , Kashiwa , Japan.
Shinya
S
Suzuki
Department of Head and Neck Medical Oncology, National Cancer Center Hospital East , Kashiwa , Japan.
Tetsuro
T
Wakasugi
Department of Head and Neck Medical Oncology, National Cancer Center Hospital East , Kashiwa , Japan.
Tomoko
T
Yamazaki
Department of Head and Neck Medical Oncology, National Cancer Center Hospital East , Kashiwa , Japan.
Susumu
S
Okano
Department of Head and Neck Medical Oncology, National Cancer Center Hospital East , Kashiwa , Japan.
Makoto
M
Tahara
cetuximab; chemotherapy; head and neck cancer; hypomagnesemia; radiotherapy; squamous cell carcinoma
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