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Grade 3 Diarrhea, CTCAE

MedGen UID:
293177
•Concept ID:
C1559310
•
Finding

Definition

Increase of >=7 stools per day over baseline; hospitalization indicated; severe increase in ostomy output compared to baseline; limiting self care ADL [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVGrade 3 Diarrhea, CTCAE

Professional guidelines

PubMed

Late adverse events in patients with pelvic cancer after oncologic treatment-intervention and treatment effect.
Iselius S, Knutsen A, Mikiver R, Uppugunduri S
Support Care Cancer 2023 Apr 13;31(5):263. doi: 10.1007/s00520-023-07733-3. PMID: 37055633Free PMC Article
Regorafenib in advanced hepatocellular carcinoma (HCC): considerations for treatment.
Kim K, Jha R, Prins PA, Wang H, Chacha M, Hartley ML, He AR
Cancer Chemother Pharmacol 2017 Nov;80(5):945-954. Epub 2017 Sep 20 doi: 10.1007/s00280-017-3431-5. PMID: 28932966
Management of sorafenib-related adverse events: a clinician's perspective.
Brose MS, Frenette CT, Keefe SM, Stein SM
Semin Oncol 2014 Feb;41 Suppl 2:S1-S16. Epub 2014 Jan 9 doi: 10.1053/j.seminoncol.2014.01.001. PMID: 24576654

Recent clinical studies

Etiology

Phase II trial demonstrates the efficacy and safety of individualized, dosimetry-based (177)Lu-DOTATATE treatment of NET patients.
Sundlöv A, Gleisner KS, Tennvall J, Ljungberg M, Warfvinge CF, Holgersson K, Hallqvist A, Bernhardt P, Svensson J
Eur J Nucl Med Mol Imaging 2022 Sep;49(11):3830-3840. Epub 2022 Apr 22 doi: 10.1007/s00259-022-05786-w. PMID: 35451612Free PMC Article
Age as a potential predictor of acute side effects during chemoradiotherapy in primary cervical cancer patients.
Holmqvist A, Lindahl G, Mikivier R, Uppungunduri S
BMC Cancer 2022 Apr 7;22(1):371. doi: 10.1186/s12885-022-09480-w. PMID: 35392858Free PMC Article
Combined use of 177Lu-DOTATATE and metronomic capecitabine (Lu-X) in FDG-positive gastro-entero-pancreatic neuroendocrine tumors.
Nicolini S, Bodei L, Bongiovanni A, Sansovini M, Grassi I, Ibrahim T, Monti M, Caroli P, Sarnelli A, Diano D, Di Iorio V, Grana CM, Cittanti C, Pieri F, Severi S, Paganelli G
Eur J Nucl Med Mol Imaging 2021 Sep;48(10):3260-3267. Epub 2021 Feb 18 doi: 10.1007/s00259-021-05236-z. PMID: 33604690Free PMC Article
Assessment of diarrhea as side effect of oral targeted antineoplastic agents in clinical practice.
Escudero-Vilaplana V, Collado-Borrell R, Del Monte-Millán M, Hoyo-Muñoz A, Gómez Martínez-Sagrera P, Revuelta-Herrero JL, Marzal-Alfaro B, Gonzalez-Haba E, López-Tarruella Cobo S, Jerez Gilarranz Y, Herranz A, Sanjurjo M, Martin M
Support Care Cancer 2021 Aug;29(8):4673-4681. Epub 2021 Jan 28 doi: 10.1007/s00520-021-06016-z. PMID: 33506273
Long-term results of robotic radiosurgery for non brachytherapy patients with cervical cancer.
Morgenthaler J, Köhler C, Budach V, Sehouli J, Stromberger C, Besserer A, Trommer M, Baues C, Marnitz S
Strahlenther Onkol 2021 Jun;197(6):474-486. Epub 2020 Sep 24 doi: 10.1007/s00066-020-01685-x. PMID: 32970164Free PMC Article

Diagnosis

Characteristics and outcome of infectious complications after autologous hematopoietic cell transplantation in multiple myeloma patients.
Jandial A, Lad D, Jain A, Khadwal A, Singh C, Prakash G, Suri V, Sreedharanunni S, Sachdeva MUS, Ray P, Varma N, Varma S, Malhotra P
Transpl Infect Dis 2023 Oct;25(5):e14123. Epub 2023 Aug 12 doi: 10.1111/tid.14123. PMID: 37573150
The effect of amino acid-oral rehydration solution (Enterade®) on chemotherapy related diarrhea and quality of life in solid tumor cancer patients: A non-randomized experimental study.
Chitwood H, Hampton D, Patel R
Eur J Oncol Nurs 2022 Oct;60:102186. Epub 2022 Aug 2 doi: 10.1016/j.ejon.2022.102186. PMID: 35970073
Long-term results of robotic radiosurgery for non brachytherapy patients with cervical cancer.
Morgenthaler J, Köhler C, Budach V, Sehouli J, Stromberger C, Besserer A, Trommer M, Baues C, Marnitz S
Strahlenther Onkol 2021 Jun;197(6):474-486. Epub 2020 Sep 24 doi: 10.1007/s00066-020-01685-x. PMID: 32970164Free PMC Article
Immune checkpoint inhibitor-related colitis assessment and prognosis: can IBD scoring point the way?
Cheung VTF, Gupta T, Olsson-Brown A, Subramanian S, Sasson SC, Heseltine J, Fryer E, Collantes E, Sacco JJ, Pirmohamed M, Simmons A, Klenerman P, Tuthill M, Protheroe AS, Chitnis M, Fairfax BP, Payne MJ, Middleton MR, Brain O
Br J Cancer 2020 Jul;123(2):207-215. Epub 2020 May 18 doi: 10.1038/s41416-020-0882-y. PMID: 32418993Free PMC Article
Intensity-modulated Radiotherapy for Anal Cancer: Dose-Volume Relationship of Acute Gastrointestinal Toxicity and Disease Outcomes.
Ng M, Ho H, Skelton J, Guerrieri M, Guiney M, Chao M, Blakey D, Macleod C, Amor H, Subramanian B, Melven L
Clin Oncol (R Coll Radiol) 2018 Oct;30(10):634-641. Epub 2018 Jul 23 doi: 10.1016/j.clon.2018.07.020. PMID: 30049649

Therapy

Safety and Efficacy of Tucatinib, Letrozole, and Palbociclib in Patients with Previously Treated HR+/HER2+ Breast Cancer.
Shagisultanova E, Gradishar W, Brown-Glaberman U, Chalasani P, Brenner AJ, Stopeck A, Parris H, Gao D, McSpadden T, Mayordomo J, Diamond JR, Kabos P, Borges VF
Clin Cancer Res 2023 Dec 15;29(24):5021-5030. doi: 10.1158/1078-0432.CCR-23-0117. PMID: 37363965Free PMC Article
Patient-reported Adverse Events During Neoadjuvant Therapy in a Phase 2 Borderline Resectable Pancreatic Cancer Clinical Trial (Alliance A021501).
Snyder RA, Dueck AC, Fruth B, Shi Q, Hubbard JM, Herman JM, O'Reilly EM, Katz MHG
Ann Surg 2023 Oct 1;278(4):598-608. Epub 2023 Jun 19 doi: 10.1097/SLA.0000000000005958. PMID: 37334719Free PMC Article
Perioperative therapy with FLOT4 significantly increases survival in patients with gastroesophageal and gastric cancer in a large real-world cohort.
Möhring C, Mańczak A, Timotheou A, Sadeghlar F, Zhou T, Mahn R, Monin MB, Toma M, Feldmann G, Brossart P, Köksal M, Sarria GR, Sommer N, Lingohr P, Jafari A, Kalff JC, Strassburg CP, Gonzalez-Carmona MA
Int J Cancer 2023 Aug 1;153(3):609-622. Epub 2023 May 5 doi: 10.1002/ijc.34511. PMID: 36919950
COLAR: open-label clinical study of IL-6 blockade with tocilizumab for the treatment of immune checkpoint inhibitor-induced colitis and arthritis.
Holmstroem RB, Nielsen OH, Jacobsen S, Riis LB, Theile S, Bjerrum JT, Vilmann P, Johansen JS, Boisen MK, Eefsen RHL, Marie Svane I, Nielsen DL, Chen IM
J Immunother Cancer 2022 Sep;10(9) doi: 10.1136/jitc-2022-005111. PMID: 36096534Free PMC Article
Patient self-reporting of tolerability using PRO-CTCAE in a randomized double-blind, placebo-controlled phase II trial comparing gemcitabine in combination with adavosertib or placebo in patients with platinum resistant or refractory epithelial ovarian carcinoma.
Madariaga A, Mitchell SA, Pittman T, Wang L, Bowering V, Kavak N, Quintos J, Chang K, Ramsahai J, Karakasis K, Welch SA, Dhani NC, Lheureux S, Oza AM
Gynecol Oncol 2022 Nov;167(2):226-233. Epub 2022 Aug 30 doi: 10.1016/j.ygyno.2022.08.006. PMID: 36055813Free PMC Article

Prognosis

Evaluation of dosimetric predictors of toxicity after IMRT with concurrent chemotherapy for anal cancer.
Lukovic J, Hosni A, Liu A, Chen J, Tadic T, Patel T, Li K, Han K, Lindsay P, Craig T, Brierley J, Barry A, Wong R, Ringash J, Dawson LA, Kim JJ
Radiother Oncol 2023 Jan;178:109429. Epub 2022 Nov 28 doi: 10.1016/j.radonc.2022.11.018. PMID: 36455685
Age as a potential predictor of acute side effects during chemoradiotherapy in primary cervical cancer patients.
Holmqvist A, Lindahl G, Mikivier R, Uppungunduri S
BMC Cancer 2022 Apr 7;22(1):371. doi: 10.1186/s12885-022-09480-w. PMID: 35392858Free PMC Article
Combined use of 177Lu-DOTATATE and metronomic capecitabine (Lu-X) in FDG-positive gastro-entero-pancreatic neuroendocrine tumors.
Nicolini S, Bodei L, Bongiovanni A, Sansovini M, Grassi I, Ibrahim T, Monti M, Caroli P, Sarnelli A, Diano D, Di Iorio V, Grana CM, Cittanti C, Pieri F, Severi S, Paganelli G
Eur J Nucl Med Mol Imaging 2021 Sep;48(10):3260-3267. Epub 2021 Feb 18 doi: 10.1007/s00259-021-05236-z. PMID: 33604690Free PMC Article
Assessment of diarrhea as side effect of oral targeted antineoplastic agents in clinical practice.
Escudero-Vilaplana V, Collado-Borrell R, Del Monte-Millán M, Hoyo-Muñoz A, Gómez Martínez-Sagrera P, Revuelta-Herrero JL, Marzal-Alfaro B, Gonzalez-Haba E, López-Tarruella Cobo S, Jerez Gilarranz Y, Herranz A, Sanjurjo M, Martin M
Support Care Cancer 2021 Aug;29(8):4673-4681. Epub 2021 Jan 28 doi: 10.1007/s00520-021-06016-z. PMID: 33506273
Immune checkpoint inhibitor-related colitis assessment and prognosis: can IBD scoring point the way?
Cheung VTF, Gupta T, Olsson-Brown A, Subramanian S, Sasson SC, Heseltine J, Fryer E, Collantes E, Sacco JJ, Pirmohamed M, Simmons A, Klenerman P, Tuthill M, Protheroe AS, Chitnis M, Fairfax BP, Payne MJ, Middleton MR, Brain O
Br J Cancer 2020 Jul;123(2):207-215. Epub 2020 May 18 doi: 10.1038/s41416-020-0882-y. PMID: 32418993Free PMC Article

Clinical prediction guides

Patient self-reporting of tolerability using PRO-CTCAE in a randomized double-blind, placebo-controlled phase II trial comparing gemcitabine in combination with adavosertib or placebo in patients with platinum resistant or refractory epithelial ovarian carcinoma.
Madariaga A, Mitchell SA, Pittman T, Wang L, Bowering V, Kavak N, Quintos J, Chang K, Ramsahai J, Karakasis K, Welch SA, Dhani NC, Lheureux S, Oza AM
Gynecol Oncol 2022 Nov;167(2):226-233. Epub 2022 Aug 30 doi: 10.1016/j.ygyno.2022.08.006. PMID: 36055813Free PMC Article
Age as a potential predictor of acute side effects during chemoradiotherapy in primary cervical cancer patients.
Holmqvist A, Lindahl G, Mikivier R, Uppungunduri S
BMC Cancer 2022 Apr 7;22(1):371. doi: 10.1186/s12885-022-09480-w. PMID: 35392858Free PMC Article
Phase II Study of Copanlisib in Patients With Tumors With PIK3CA Mutations: Results From the NCI-MATCH ECOG-ACRIN Trial (EAY131) Subprotocol Z1F.
Damodaran S, Zhao F, Deming DA, Mitchell EP, Wright JJ, Gray RJ, Wang V, McShane LM, Rubinstein LV, Patton DR, Williams PM, Hamilton SR, Suga JM, Conley BA, Arteaga CL, Harris LN, O'Dwyer PJ, Chen AP, Flaherty KT
J Clin Oncol 2022 May 10;40(14):1552-1561. Epub 2022 Feb 8 doi: 10.1200/JCO.21.01648. PMID: 35133871Free PMC Article
Assessment of diarrhea as side effect of oral targeted antineoplastic agents in clinical practice.
Escudero-Vilaplana V, Collado-Borrell R, Del Monte-Millán M, Hoyo-Muñoz A, Gómez Martínez-Sagrera P, Revuelta-Herrero JL, Marzal-Alfaro B, Gonzalez-Haba E, López-Tarruella Cobo S, Jerez Gilarranz Y, Herranz A, Sanjurjo M, Martin M
Support Care Cancer 2021 Aug;29(8):4673-4681. Epub 2021 Jan 28 doi: 10.1007/s00520-021-06016-z. PMID: 33506273
Regorafenib in advanced hepatocellular carcinoma (HCC): considerations for treatment.
Kim K, Jha R, Prins PA, Wang H, Chacha M, Hartley ML, He AR
Cancer Chemother Pharmacol 2017 Nov;80(5):945-954. Epub 2017 Sep 20 doi: 10.1007/s00280-017-3431-5. PMID: 28932966

Recent systematic reviews

A Systematic Review and Meta-analysis of the Effectiveness and Toxicities of Lutetium-177-labeled Prostate-specific Membrane Antigen-targeted Radioligand Therapy in Metastatic Castration-Resistant Prostate Cancer.
Sadaghiani MS, Sheikhbahaei S, Werner RA, Pienta KJ, Pomper MG, Solnes LB, Gorin MA, Wang NY, Rowe SP
Eur Urol 2021 Jul;80(1):82-94. Epub 2021 Apr 8 doi: 10.1016/j.eururo.2021.03.004. PMID: 33840558Free PMC Article
Prophylactic probiotics for cancer therapy-induced diarrhoea: a meta-analysis.
Wardill HR, Van Sebille YZA, Ciorba MA, Bowen JM
Curr Opin Support Palliat Care 2018 Jun;12(2):187-197. doi: 10.1097/SPC.0000000000000338. PMID: 29547491

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