title: Dermatologic adverse events in pediatric patients receiving targeted anticancer therapies: a pooled analysis.
abstract: BACKGROUND
  The dermatologic adverse events (AEs) of various molecularly targeted therapies are well-described in adult cancer patients. Little has been reported on the incidence and clinical presentation of such AEs in pediatric patients with cancer. To address this gap, we analyzed the dermatologic AEs reported across clinical trials of targeted anticancer therapies in pediatric patients.
  
  
  METHODS
  We conducted an electronic literature search (PubMed, American Society of Clinical Oncology annual meetings' abstracts, ClinicalTrials.gov, NCI's Pediatric Oncology Branch webpage) to identify clinical trials involving targeted anticancer therapies that reported dermatologic AEs in their safety data. Studies were limited to the pediatric population, monotherapy trials (oncology), and English language publications.
  
  
  RESULTS
  Pooled data from 19 clinical studies investigating 11 targeted anticancer agents (alemtuzumab, rituximab, imatinib, dasatinib, erlotinib, vandetanib, sorafenib, cabozantinib, pazopanib, everolimus, and temsirolimus) were analyzed. The most frequently encountered dermatologic AEs were rash (127/660; 19%), xerosis (18/100; 18%), mucositis (68/402; 17%), and pruritus (12/169; 7%). Other AEs included pigmentary abnormalities of the skin/hair (13%), hair disorders (trichomegaly, hypertrichosis, alopecia, and madarosis; 14%), urticaria (7%), palmoplantar erythrodysesthesia (7%), erythema, acne, purpura, skin fissures, other 'unknown skin changes', exanthem, infection, flushing, telangiectasia, and photosensitivity.
  
  
  CONCLUSIONS
  This study describes the dermatologic manifestations of targeted anticancer therapy-related AEs in the pediatric population. Since these AEs are often associated with significant morbidity, it is imperative that pediatric oncologists be familiar with their recognition and management, to avoid unnecessary dose modifications and/or termination, and to prevent impairments in patients' quality of life.
authors: Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, NY USA.
authors: Viswanath Reddy
authors: VR
authors: Belum
authors: Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, NY USA.|Philadelphia College of Osteopathic Medicine, Suwanee, GA, USA.
authors: Courtney
authors: C
authors: Washington
authors: Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY USA.
authors: Christine A
authors: CA
authors: Pratilas
authors: Department of Dermatology, Institut Claudius Regaud, Institut Universitaire Cancer Toulouse-oncopole, Toulouse, France.
authors: Vincent
authors: V
authors: Sibaud
authors: Unité de Dermatologie Pédiatrique, Hôpital Pellegrin-enfants, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France.
authors: Franck
authors: F
authors: Boralevi
authors: Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, NY USA.
authors: Mario E
authors: ME
authors: Lacouture
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002986:Clinical Trials as Topic; D006801:Humans; D015201:Meta-Analysis as Topic; D058990:Molecular Targeted Therapy / Q000009:adverse effects*; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents
keywords: adverse events; dermatologic; mucositis; pediatric; pruritus; rash; targeted therapies