title: Management of cutaneous adverse events induced by anti-EGFR (epidermal growth factor receptor): a French interdisciplinary therapeutic algorithm.
abstract: OBJECTIVE
  Cutaneous adverse events induced by epidermal growth factor receptor (EGFR) inhibitors can hamper the patients' quality of life. The aim of our work was to draft an algorithm for the optimised management of this skin toxicity.
  
  
  METHODS
  This algorithm was built in three steps under the responsibility of a steering committee. Step I: a systematic literature analysis (SLA) has been performed. Step II: the collection of information about practices was performed through a questionnaire.These questions were asked during regional meetings to which oncologists, gastro-enterologists, radiotherapists, and dermatologists were invited. Step III: a final meeting was organised involving the bibliography group and the steering committee and regional scientific committees for proposing a final algorithm.
  
  
  RESULTS
  Step I: 14 publications were selected to evaluate the use of cyclines as curative or prophylactic treatment of the folliculitis induced by EGFR inhibitors. Nineteen publications were retained for the topical treatment of the folliculitis. Forty-six articles were selected for the management of the cutaneous lesions in link with appendages and 12 for xerosis and pruritus. Step II: 96 delegates attended the seven regional meetings and 67 questionnaires were analysed. Step III: a final algorithm was proposed on the basis of the conclusions of the first two steps and expert opinions present at this final meeting. The different propositions were unanimously approved by the 14 experts who voted.
  
  
  CONCLUSIONS
  This multidisciplinary study summarising published data and current practices produced a therapeutic algorithm, which should facilitate the standardised, optimised management of skin toxicity associated with EGFR inhibitors in France.
authors.affiliation: Department of Dermatology, CHU Reims, Hôpital Robert Debré, avenue du Général Koenig, 51092 Reims, France. zreguiai@chu-reims.fr
authors.forename: Z
authors.initials: Z
authors.lastname: Reguiai
authors.forename: J B
authors.initials: JB
authors.lastname: Bachet
authors.forename: C
authors.initials: C
authors.lastname: Bachmeyer
authors.forename: L
authors.initials: L
authors.lastname: Peuvrel
authors.forename: M
authors.initials: M
authors.lastname: Beylot-Barry
authors.forename: M
authors.initials: M
authors.lastname: Bezier
authors.forename: E
authors.initials: E
authors.lastname: Boucher
authors.forename: C
authors.initials: C
authors.lastname: Chevelle
authors.forename: P
authors.initials: P
authors.lastname: Colin
authors.forename: R
authors.initials: R
authors.lastname: Guimbaud
authors.forename: L
authors.initials: L
authors.lastname: Mineur
authors.forename: M A
authors.initials: MA
authors.lastname: Richard
authors.forename: P
authors.initials: P
authors.lastname: Artru
authors.forename: P
authors.initials: P
authors.lastname: Dufour
authors.forename: J M
authors.initials: JM
authors.lastname: Gornet
authors.forename: E
authors.initials: E
authors.lastname: Samalin
authors.forename: R J
authors.initials: RJ
authors.lastname: Bensadoun
authors.forename: M
authors.initials: M
authors.lastname: Ychou
authors.forename: T
authors.initials: T
authors.lastname: André
authors.forename: B
authors.initials: B
authors.lastname: Dreno
authors.forename: O
authors.initials: O
authors.lastname: Bouché
mesh_terms: D000465:Algorithms; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003875:Drug Eruptions / Q000209:etiology; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D005499:Folliculitis / Q000139:chemically induced / Q000188:drug therapy; D005602:France; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013754:Tetracyclines / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D013754:Tetracyclines; D066246:ErbB Receptors