Adverse event management:
If possible, the first step in treating decreased appetite is to address the underlying cause:
- Addressing symptoms of nausea may help improve appetite
- Treatment for any conditions such as mouth sores, dry mouth, pain or depression may help
to improve appetite
- Additional treatments for appetite loss and associated weight loss may include medications that
increase appetite, medications that help food move through the intestine and nutritional supplements
- Continue GIOTRIF® (afatinib) treatment at current dose
Grade ≥3 or intolerable Grade 2:
- Interrupt GIOTRIF® (afatinib), resuming treatment at a reduced dose (10 mg lower) if patient recovers to grade ≤1. Permanent discontinuation should be considered in patients who cannot tolerate 20 mg/day of GIOTRIF® (afatinib) treatment
Advice for patients1
- Eat 5–6 small meals a day and snack when hungry
- Identify the times of day when usually hungry − eat at those times and do not limit the amount eaten
- Eat nutritious snacks that are high in calories and protein, such as dried fruits, nuts, yogurt, cheeses, eggs, milkshakes, ice cream, cereal and muesli bars
- Drink fluids between meals, instead of with meals, to avoid filling up too quickly
- When too tired to shop/cook, ask family members or friends for help; consider buying pre-cooked meals
- If the smell or taste of food brings on nausea, eat cold/room temperature food to decrease odour and reduce taste
- Meet with a dietitian for additional advice on meal planning
Adapted from CTCAE version 3.3
CTCAE=Common Terminology Criteria for Adverse Events, TPN=total parenteral nutrition
- Cancer.Net. Appetite Loss. Available at: www.cancer.net/all-about-cancer/treating-cancer/managing-side-effects/ap.... Last accessed April 2019.
- GIOTRIF® (afatinib) Summary of Product Characteristics, 2018.
- Common Terminology Criteria for Adverse Events (CTCAE) Version 3.0.