title: Managing skin toxicities related to panitumumab.
abstract: BACKGROUND
  Dermatologic toxicities from targeted agents such as panitumumab can interfere with cancer treatment.
  
  
  OBJECTIVE
  We sought to evaluate the rash assessment and management in a consecutive patient cohort who received panitumumab for colorectal cancer treatment.
  
  
  METHODS
  This was a retrospective chart review.
  
  
  RESULTS
  Skin toxicity, consisting of papulopustular rash, was experienced by 32 of 34 patients. The majority (85%) developed the rash by the end of the second infusion cycle. Patients presented with a mild (41%), moderate (38%), and severe (21%) rash, and progressed to an extensive rash without appropriate treatment. A grading system was used for 65% of patients to document severity.
  
  
  CONCLUSIONS
  Small sample size limited power in analysis. Rash severity had to be inferred based on rash description and management in 11 of the patients.
  
  
  CONCLUSIONS
  Dermatologic toxicities related to panitumumab are common; however, the way they are reported and managed varies among physicians. To prevent progression, toxicities must be assessed and treated early and aggressively, according to severity grading. Dermatologists could aid oncologists in choosing the best management strategies.
authors.affiliation: Department of Clinical Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada. Electronic address: hbergman@uhnres.utoronto.ca.
authors.forename: Hagit
authors.initials: H
authors.lastname: Bergman
authors.affiliation: Ontario Patient-Reported Outcomes of Symptoms and Toxicity, Princess Margaret Cancer Center and Ontario Cancer Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Tara
authors.initials: T
authors.lastname: Walton
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ryan
authors.initials: R
authors.lastname: Del Bel
authors.affiliation: Department of Pharmacy, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jack T
authors.initials: JT
authors.lastname: Seki
authors.affiliation: Department of Clinical Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ava
authors.initials: A
authors.lastname: Rafii
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Clinical Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
authors.affiliation: Department of Dermatology, Sunnybrook Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Neil
authors.initials: N
authors.lastname: Shear
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Ontario Patient-Reported Outcomes of Symptoms and Toxicity, Princess Margaret Cancer Center and Ontario Cancer Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Medical Oncology and Hematology Division, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Monika K
authors.initials: MK
authors.lastname: Krzyzanowska
authors.affiliation: Ontario Patient-Reported Outcomes of Symptoms and Toxicity, Princess Margaret Cancer Center and Ontario Cancer Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Doris
authors.initials: D
authors.lastname: Howell
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Ontario Patient-Reported Outcomes of Symptoms and Toxicity, Princess Margaret Cancer Center and Ontario Cancer Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Medical Oncology and Hematology Division, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Liu
mesh_terms: D017486:Acneiform Eruptions / Q000139:chemically induced / Q000188:drug therapy; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D003879:Dermatologic Agents / Q000627:therapeutic use; D003875:Drug Eruptions / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D005076:Exanthema / Q000139:chemically induced* / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D000077544:Panitumumab; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D003879:Dermatologic Agents; D000077544:Panitumumab
keywords: Common Toxicity Criteria for Adverse Events; epidermal growth factor receptor inhibitors; panitumumab; papulopustular rash; skin toxicity