The management of skin reactions in cancer patients receiving epidermal growth factor receptor targeted therapies.
The use of epidermal growth factor receptor (EGFR) inhibitors for the treatment of solid tumours is increasing. However, the tolerability profile for EGFR-inhibitors, such as the monoclonal antibody cetuximab and the tyrosine kinase inhibitor erlotinib, is characterised by a unique group of skin reactions dominated by an acneiform eruption, xerosis, eczema and changes in the hair and nails. The possibility that this skin toxicity correlates with anti-tumour activity offers the potential to titrate dosing on a case-by-case basis. These skin effects may constitute a significant obstacle to treatment compliance. Accordingly, there is a need for consistent, multi-disciplinary management strategies that will allow patients to receive the recommended dosages of such targeted therapies. The eruption responds well to some acne therapies and xerosis can be controlled by standard emollients. Here we present an overview of the treatment options for skin reactions that are available today, and evaluate some of the ways in which the treatment of such EGFR-inhibitor-related skin reactions may be improved in the future. Evidence-based studies are needed to determine the best way to manage these effects.
Segaert
Siegfried
S
Department of Dermatology, Katholieke Universiteit Leuven, Belgium. Siegfried.Segaert@med.kuleuven.be
Tabernero
Josep
J
Chosidow
Olivier
O
Dirschka
Thomas
T
Elsner
Joern
J
Mancini
Luca
L
Maughan
Tim
T
Morere
Jean-Fran Ois
JF
Santoro
Armando
A
Sobrero
Alberto
A
Van Cutsem
Eric
E
Layton
Alison
A
D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000068818:Cetuximab; D003875:Drug Eruptions / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D000069347:Erlotinib Hydrochloride; D005544:Forecasting; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D000077544:Panitumumab; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D011799:Quinazolines / Q000009:adverse effects*
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000077544:Panitumumab; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors; D000068818:Cetuximab