Prophylactic Effect of Oral Minocycline in Combination with Topical Steroid and Skin Care Against Panitumumab-induced Acneiform Rash in Metastatic Colorectal Cancer Patients.
BACKGROUND
Although the anti-EGFR monoclonal antibody panitumumab is effective in treating colorectal cancer, the occurrence of severe skin disorders often discontinues therapy. Herein, we investigated by a retrospective chart review the effect of prophylactic oral minocycline in combination with skin treatment using moisturizer on the incidence of skin disorders and tumor response in metastatic colorectal cancer patients who received panitumumab.


METHODS
In a total of 55 patients, 38 patients were eligible, consisting the pre-emptive group (N=25) and reactive group (N=13). Acneiform rash and other adverse events were graded according to the CTCAE v4.0.


RESULTS
The occurrence of acneiform rash (grade ≥2) was significantly lower in pre-emptive group than in reactive group (44.0% vs. 84.6%, p=0.04). No significant differences in the occurrence of other adverse events were observed between the two groups. Tumor response was not significantly different between the two groups (36.0% vs. 7.7%, OR, 6.75; 95% confidence interval (CI)=0.75-60.76, p=0.12). Mean time to treatment failure was 149.7 days and 110.2 days in the pre-emptive group and reactive treatment group, respectively (HR=0.58; 95% CI= 0.26-1.28, p=0.18).


CONCLUSIONS
Prophylactic oral minocycline combined with skin care reduced panitumumab-induced acneiform rash without a significant influence on tumor response.
Department of Pharmacy, Gifu University Hospital, Gifu, Japan maya@gifu-u.ac.jp.
Maya
M
Yamada
Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
Hirotoshi
H
Iihara
Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
Hironori
H
Fujii
Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
Masashi
M
Ishihara
Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan.
Nobuhisa
N
Matsuhashi
Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan.
Takao
T
Takahashi
Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan.
Kazuhiro
K
Yoshida
Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
Yoshinori
Y
Itoh
D017486:Acneiform Eruptions / Q000139:chemically induced / Q000517:prevention & control*; D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004359:Drug Therapy, Combination; D005076:Exanthema / Q000139:chemically induced / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use*; D009367:Neoplasm Staging; D000077544:Panitumumab; D011379:Prognosis; D017592:Skin Care
D000900:Anti-Bacterial Agents; D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000077544:Panitumumab; D008911:Minocycline
acneiform rash; colorectal cancer; minocycline; panitumumab; skin care; time to treatment failure; tumor response