title: Docetaxel-induced skin toxicities in breast cancer patients subsequent to paclitaxel shortage: a case series and literature review.
abstract: OBJECTIVE
  As the result of a recent national shortage in paclitaxel, some patients who were receiving or scheduled to receive weekly paclitaxel were converted to every 3-week (q3w) docetaxel with granulocyte colony-stimulating factor support. Our institution noted higher than expected incidence of severe skin toxicity events attributable to docetaxel during the shortage period among our breast cancer patients. In this report, we summarize the clinical course of the first five cases, review the literature surrounding docetaxel-induced skin toxicity, and offer possible prevention and treatment strategies to improve docetaxel tolerability.
  
  
  METHODS
  The observation period for this case series was August 1 through October 21, 2011. All patients treated with docetaxel were identified from our electronic medical record. Operable stage I-III breast cancer patients who received ≥ 1 dose of docetaxel monotherapy at 75-100 mg/m(2) q3w were included in this study. The cases of grade 3-4 docetaxel-induced skin toxicities identified by the treating oncologists were then contacted and signed an informed consent through an Institutional Review Board-approved protocol.
  
  
  RESULTS
  Thirty-four patients met the inclusion criteria. Five patients (14.7 %) experienced grade 3 skin toxicity events attributable to docetaxel, a significantly higher rate than previously reported for docetaxel dosed at 75-100 mg/m(2).
  
  
  CONCLUSIONS
  Docetaxel-induced dermatologic toxicity is well characterized; nonetheless, its etiology is largely unknown and evidence-based prevention and management strategies are lacking. This report shows that the use of docetaxel 75-100 mg/m(2) q3w subsequent to dose-dense doxorubicin and cyclophosphamide regimen can lead to unacceptable rate of severe skin toxicity.
authors.affiliation: Department of Pharmacy, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, 300 W 10th Ave, Columbus, OH, 43210, USA.
authors.forename: Ming J
authors.initials: MJ
authors.lastname: Poi
authors.forename: Michael
authors.initials: M
authors.lastname: Berger
authors.forename: Maryam
authors.initials: M
authors.lastname: Lustberg
authors.forename: Rachel
authors.initials: R
authors.lastname: Layman
authors.forename: Charles L
authors.initials: CL
authors.lastname: Shapiro
authors.forename: Bhuvaneswari
authors.initials: B
authors.lastname: Ramaswamy
authors.forename: Ewa
authors.initials: E
authors.lastname: Mrozek
authors.forename: Erin
authors.initials: E
authors.lastname: Olson
authors.forename: Robert
authors.initials: R
authors.lastname: Wesolowski
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000600:supply & distribution*; D001943:Breast Neoplasms / Q000188:drug therapy*; D000077143:Docetaxel; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects / Q000600:supply & distribution*; D012871:Skin Diseases / Q000139:chemically induced*; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D016179:Granulocyte Colony-Stimulating Factor; D000077143:Docetaxel; D017239:Paclitaxel