title: Does sunscreen prevent epidermal growth factor receptor (EGFR) inhibitor-induced rash? Results of a placebo-controlled trial from the North Central Cancer Treatment Group (N05C4).
abstract: OBJECTIVE
  Rash occurs in >50% of patients prescribed epidermal growth factor receptor (EGFR) inhibitors. This study was undertaken to determine whether sunscreen prevents or mitigates these rashes.
  
  
  METHODS
  This placebo-controlled, double-blinded trial enrolled rash-free patients starting an EGFR inhibitor. Patients were randomly assigned to sunscreen with a sun protection factor of 60 applied twice a day for 28 days versus placebo. They were then monitored for rash and quality of life (Skindex-16) during the 4-week intervention and for an additional 4 weeks.
  
  
  RESULTS
  Fifty-four patients received sunscreen, and 56 received placebo; the arms were balanced at baseline. During the 4-week intervention, physician-reported rash occurred in 38 (78%) and 39 (80%) sunscreen-treated and placebo-exposed patients, respectively (p = 1.00); no significant differences in rash rates emerged over the additional 4 weeks. There were no significant differences in rash severity, and patient-reported outcomes of rash yielded similar conclusions. Adjustment for sun intensity by geographical zone, season, and use of photosensitivity medications did not yield a significant difference in rash across study arms (p = .20). Quality of life scores declined but remained comparable between arms.
  
  
  CONCLUSIONS
  Sunscreen, as prescribed in this trial, did not prevent or attenuate EGFR inhibitor-induced rash.
authors.affiliation: Mayo Clinic Foundation, Rochester, Minnesota 55905, USA. jatoi.aminah@mayo.edu
authors.forename: Aminah
authors.initials: A
authors.lastname: Jatoi
authors.forename: Abby
authors.initials: A
authors.lastname: Thrower
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Flynn
authors.forename: Nicole Lea
authors.initials: NL
authors.lastname: Wentworth-Hartung
authors.forename: Shaker R
authors.initials: SR
authors.lastname: Dakhil
authors.forename: Bassam I
authors.initials: BI
authors.lastname: Mattar
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Nikcevich
authors.forename: Paul
authors.initials: P
authors.lastname: Novotny
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Sekulic
authors.forename: Charles L
authors.initials: CL
authors.lastname: Loprinzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000068818:Cetuximab; D004311:Double-Blind Method; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D000069347:Erlotinib Hydrochloride; D005076:Exanthema / Q000139:chemically induced / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life; D011799:Quinazolines / Q000009:adverse effects*; D013473:Sunscreening Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D011799:Quinazolines; D013473:Sunscreening Agents; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors; D000068818:Cetuximab
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