Congress Abstracts 2005

95

SKIN TOXICITIES AND GEFITINIB (IRESSA): A NURSING CARE PLAN. Ann Culkin, RN, Barbara Pizzo, RN, OCN^®, BSN, and Leslie Tyson, MS, ANP-BC, OCN^®, Memorial Sloan-Kettering Cancer Center, New York, NY.

Gefitinib (Iressa, ZD-1839) was approved in Japan in 2002 and in the United States in 2003 as third line treatment regimen for patients with Non Small Cell Lung Cancer (NSCLC). Daily oral self medication of gefitinib is well tolerated. The side effects are inherently different from those of conventional cytotoxic agents as it does not cause the myelosuppression and nausea or vomiting frequently associated with “conventional” chemotherapy. Effective assessment and interventions for this continuing side effect profile is emerging and requires specific nursing monitoring and interventions.

The purpose of this presentation is to educate oncology nurses in accurate assessment and interventions specific to this exciting new compound. In the US, investigators reported skin toxicity in 62% of patients. Rashes typically consist of pustular or acne-like lesion with occasional erythema and/or pruritus; they are usually located on the face, neck and trunk. Dermatologic changes can include skin desquamation, slow-healing cuts, nail/cuticle cracking and nasal ulcers.

Treatment interventions are specific to the severity of the rash. The thoracic oncology nurses at this NCI-designated comprehensive cancer center have developed a patient fact card, patient education materials, and nursing care plan for patients receiving this unique treatment.

Most patients had a high level of tolerance for the dermatologic effects associated with gefitinib, which were milder than toxicities associated with chemotherapy.

This presentation will include a comprehensive nursing care plan highlighting the cutaneous reactions and nursing interventions designed to manage the dermatologic changes seen in patients ingesting gefitinib.

This care plan could be used by oncology nurses to provide education and interventions for patients receiving this treatment.