title: Dermatologic adverse events associated with afatinib: an oral ErbB family blocker.
abstract: Dermatologic adverse events (AEs) are frequently observed in patients receiving EGF receptor (EGFR; also known as ErbB1) tyrosine kinase inhibitor therapy. The impact of these AEs goes beyond cosmesis to the discomfort from itching, pain and secondary infections, all of which may significantly impact on patient well-being, adherence and clinical outcomes. Afatinib is a potent, irreversible, oral, ErbB family blocker, inhibiting EGFR (ErbB1), HER2 (ErbB2) and ErbB4 receptor kinases. It also inhibits transphosphorylation of ErbB3. Similar to EGFR inhibitors, dermatologic AEs have been frequently observed in patients treated with afatinib. Papulopustular (acneiform) rash, pruritus, xerosis, paronychia and alopecia will require patient education and proactive treatment interventions. This article summarizes current data on the dermatologic AEs associated with afatinib treatment across the clinical trial program, and provides strategies for their effective management.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, NY, USA. lacoutum@mskcc.org
authors.forename: Mario E
authors.initials: ME
authors.lastname: Lacouture
authors.forename: Dirk
authors.initials: D
authors.lastname: Schadendorf
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Chu
authors.forename: Martina
authors.initials: M
authors.lastname: Uttenreuther-Fischer
authors.forename: Uz
authors.initials: U
authors.lastname: Stammberger
authors.forename: Dennis
authors.initials: D
authors.lastname: O'Brien
authors.forename: Axel
authors.initials: A
authors.lastname: Hauschild
mesh_terms: D000284:Administration, Oral; D000077716:Afatinib; D000505:Alopecia / Q000139:chemically induced; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005076:Exanthema / Q000139:chemically induced; D006801:Humans; D010304:Paronychia / Q000139:chemically induced; D047428:Protein Kinase Inhibitors / Q000009:adverse effects; D011537:Pruritus / Q000139:chemically induced; D011799:Quinazolines / Q000008:administration & dosage* / Q000009:adverse effects*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors
chemical_list: D000077716:Afatinib; D066246:ErbB Receptors; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human