An interdisciplinary consensus on managing skin reactions associated with human epidermal growth factor receptor inhibitors.
The use of human epidermal growth factor receptor (HER1/EGFR) inhibitors, such as erlotinib, cetuximab, and panitumumab, often is accompanied by the development of a characteristic spectrum of skin toxicities. Although these toxicities rarely are life threatening, they can cause physical and emotional distress for patients and caregivers. As a result, practitioners often withdraw the drug, potentially depriving patients of a beneficial clinical outcome. These reactions do not necessarily require any alteration in HER1/EGFR-inhibitor treatment and often are best addressed through symptomatic treatment. Although the evidence for using such therapies is limited, an interdisciplinary HER1/EGFR-inhibitor dermatologic toxicity forum was held in October 2006 to discuss the underlying mechanisms of these toxicities and evaluate commonly used therapeutic interventions. The result was a proposal for a simple, three-tiered grading system for skin toxicities related to HER1/EGFR inhibitors to be used in therapeutic decision making and as a framework for building a stepwise approach to intervention.
Eaby
Beth
B
University of Pennsylvania, Philadelphia, PA, USA. eabyb@uphs.upenn.edu
Culkin
Ann
A
Lacouture
Mario E
ME
D000465:Algorithms; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000009:adverse effects*; D019985:Benchmarking; D000068818:Cetuximab; D003663:Decision Trees; D003875:Drug Eruptions / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D000069347:Erlotinib Hydrochloride; D019317:Evidence-Based Medicine; D006801:Humans; D015994:Incidence; D000077544:Panitumumab; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D011799:Quinazolines / Q000009:adverse effects; D012720:Severity of Illness Index
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