Strategies to Minimize Toxicities, and the Pharmacist’s Role in Educating and Supporting Patients With NSCLC

EP: 1.Overcoming Challenges in NSCLC Management From a Pharmacist’s Perspective

EP: 2.First-Line Focus: Molecular Testing and Guideline-Directed Therapy in EGFR-Positive NSCLC

EP: 3.Recent Clinical Trial Highlights for NSCLC Treatment

EP: 4.Integrating Clinical Trial Findings Into Everyday Pharmacy Practice

EP: 5.Barriers to Bridging Clinical Trial Data to Routine Pharmacy Practice

EP: 6.Enhancing Patient Care Through Multidisciplinary Team Collaboration in Management of NSCLC

EP: 7.Breaking New Ground: Emerging Therapies for Treatment of EGFR-Positive NSCLC

EP: 8.Balancing Treatment and Quality of Life: Adverse Events of First-Line Agents in NSCLC

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EP: 9.Strategies to Minimize Toxicities, and the Pharmacist’s Role in Educating and Supporting Patients With NSCLC

Management Strategies for EGFR TKI Adverse Effects: Summary for Physicians

Dermatologic Toxicity Management

• Proactive skin care regimen before initiating EGFR TKIs:
• Recommend non–alcohol-based creamy moisturizers (morning and night)

• Daily SPF 30+ sunscreen on exposed areas

• Encourage protective clothing (hats, long sleeves)
• Treatment options for acneiform rash:
• Topical steroids

• Topical clindamycin gel

• Oral doxycycline (helps reduce severity and prevent superimposed infection)

• Consider dermatology referral for severe cases

Diarrhea Management

• Patient education:
• Instruct patients to monitor and track stool frequency above baseline

• Emphasize adequate hydration
• Dietary modifications:
• Recommend BRAT-style diet (bananas, rice, apples, toast)

• Low-fiber, bland foods

• Avoid dairy, greasy, and fatty foods
• Pharmacologic intervention:
• Provide step-by-step loperamide (Imodium) dosing instructions

• Review medication list for potential exacerbating agents

• Instruct patients to hold laxatives/stool softeners during diarrhea episodes

Clinical Pearls

• Male patients may require additional encouragement regarding skin care regimens
• Emphasize importance of patient communication between visits
• Always perform medication reconciliation to identify potential contributory medications
• Ensure patients have clear instructions for all prescribed treatments

This approach focuses on proactive management to minimize adverse events while maintaining treatment efficacy.