5.1 Adverse reactions to targeted treatment

5.1 Adverse reactions to targeted treatment¹

Adverse reactions to the treatment are graded in accordance with common terminology criteria for adverse events (CTCAE) version 5.0, which is graded from 0–5 according to severity. There are online versions/apps of CTCAE that describe/grade adverse reactions from each organ system. In general, the higher the level, the more severe the adverse reaction, which will require some form of intervention.

GRADING OF ADVERSE REACTIONS
Grade 1	Mild • Asymptomatic or mild symptoms • Clinical or diagnostic observation only indicated • No indication for intervention
Grade 2	Moderate • Minimal, local or non-invasive intervention indicated • Limits activities of daily living (ADL) corresponding to age
Grade 3	Severe or significant, but not life-threatening • Admission or extended hospitalisation • Disabling • Limits self-care
Grade 4	Life-threatening • Urgent intervention required
Grade 5	Death related to treatment/adverse reaction

Possible adverse reactions to TKI/mTOR inhibitors

Below is a list of the most frequent adverse reactions to targeted treatment. Management of adverse reactions in relation to the individual organ systems is described in section on managing TKI adverse reactions:

Fatigue/tiredness
Gastrointestinal
- Stomatitis
- Nausea/reduced appetite/vomiting
- Diarrhoea
- Abdominal pain/cramps
Skin
- Hand/foot syndrome
- Dry skin
Changed hair colour
Bleeding/thromboses
Hypothyroidism
Cardio
- Hypertension
- Drop in EF
- Prolonged QTc