title: Prognosis in patients with non-small cell lung cancer who received erlotinib treatment and subsequent dose reduction due to skin rash.
abstract: BACKGROUND
  Severe skin rash as toxicity of erlotinib has been reported in relation to better response and survival. However, some patients require dose reduction due to skin toxicities, and their prognosis remains uncertain. We retrospectively evaluated the clinical course of non-small cell lung cancer patients receiving erlotinib at a reduced dose because of skin rash.
  
  
  METHODS
  Among 76 patients treated with erlotinib, 55 patients who developed skin rash severer than grade 2 were divided into 2 groups: 24 patients treated with erlotinib with dose reduction because of skin rash (dose reduction group) and 31 patients without any dose reduction (non-dose reduction group).
  
  
  RESULTS
  The median progression-free survival in the dose reduction and non-dose reduction groups was 341 and 70 days, respectively, and the median overall survival was 566 and 202 days, respectively (p < 0.001). In the dose reduction group, no smoking history, female sex, epidermal growth factor receptor gene mutation, and grade 3 skin rash were significant baseline factors.
  
  
  CONCLUSIONS
  Patients who received erlotinib at a reduced dose following skin rash showed better survival than those without reduction. In cases of intolerable skin rash, patients may benefit from continuous treatment with a reduced dose of erlotinib.
authors.affiliation: Department of Pharmacy, Tosei General Hospital, Seto, Aichi, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Takashima
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kimura
authors.forename: Naohiro
authors.initials: N
authors.lastname: Watanabe
authors.forename: Takumi
authors.initials: T
authors.lastname: Umemura
authors.forename: Shinya
authors.initials: S
authors.lastname: Katsuno
authors.forename: Keiko
authors.initials: K
authors.lastname: Arakawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fukatsu
authors.forename: Naoto
authors.initials: N
authors.lastname: Nakamura
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishiyama
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kataoka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kondoh
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Taniguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality*; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D003875:Drug Eruptions / Q000453:epidemiology* / Q000517:prevention & control*; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use*; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride