title: Evolving strategies for the management of hand-foot skin reaction associated with the multitargeted kinase inhibitors sorafenib and sunitinib.
abstract: The multitargeted kinase inhibitors (MKIs) sorafenib and sunitinib have shown benefit in patients with renal cell carcinoma, hepatocellular carcinoma (sorafenib), and gastrointestinal stromal tumor (sunitinib). Their efficacy in other malignancies is currently being investigated because of their broad range of activity. The effectiveness of these drugs is somewhat diminished by the development of a variety of toxicities, most notably hand-foot skin reaction (HFSR). Although HFSR does not appear to directly affect survival, it can impact quality of life and lead to MKI dose modification or interruption, potentially limiting the antitumor effect. Currently, no standard guidelines exist for the prevention and management of MKI-associated HFSR. To address this issue, an international, interdisciplinary panel of experts gathered in January 2008 to discuss and evaluate the best-practice management of these reactions. Based on these proceedings, recommendations for the management of HFSR have been provided to offer patients the best possible quality of life while taking these drugs and to optimize the patient benefit associated with MKI therapy.
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. m-lacouture@northwestern.edu
authors.forename: Mario E
authors.initials: ME
authors.lastname: Lacouture
authors.forename: Shenhong
authors.initials: S
authors.lastname: Wu
authors.forename: Caroline
authors.initials: C
authors.lastname: Robert
authors.forename: Michael B
authors.initials: MB
authors.lastname: Atkins
authors.forename: Heidi H
authors.initials: HH
authors.lastname: Kong
authors.forename: Joan
authors.initials: J
authors.lastname: Guitart
authors.forename: Claus
authors.initials: C
authors.lastname: Garbe
authors.forename: Axel
authors.initials: A
authors.lastname: Hauschild
authors.forename: Igor
authors.initials: I
authors.lastname: Puzanov
authors.forename: Doru T
authors.initials: DT
authors.lastname: Alexandrescu
authors.forename: Roger T
authors.initials: RT
authors.lastname: Anderson
authors.forename: Laura
authors.initials: L
authors.lastname: Wood
authors.forename: Janice P
authors.initials: JP
authors.lastname: Dutcher
mesh_terms: D001557:Benzenesulfonates / Q000009:adverse effects* / Q000494:pharmacology; D005533:Foot Dermatoses / Q000139:chemically induced* / Q000628:therapy*; D006229:Hand Dermatoses / Q000139:chemically induced* / Q000628:therapy*; D006801:Humans; D007211:Indoles / Q000009:adverse effects* / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000494:pharmacology; D011725:Pyridines / Q000009:adverse effects* / Q000494:pharmacology; D011758:Pyrroles / Q000009:adverse effects* / Q000627:therapeutic use; D011788:Quality of Life; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors; D000077157:Sorafenib; D000077210:Sunitinib
chemical_list: D001557:Benzenesulfonates; D007211:Indoles; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D011725:Pyridines; D011758:Pyrroles; D009536:Niacinamide; D000077157:Sorafenib; D040262:Receptors, Vascular Endothelial Growth Factor; D000077210:Sunitinib