Cetuximab-Associated Elongation of the Eyelashes

Abstract

Eyelash trichomegaly is an uncommon drug-associated sequelae experienced during treatment with epidermal growth factor receptor (EGFR) inhibitors. Elongation of the eyelashes induced by these agents has predominantly been observed in oncology patients with either colorectal or lung cancer. It is most frequently associated with cetuximab and erlotinib; however, it has also been described in individuals treated with gefitinib or panitumumab. We describe cetuximab-associated eyelash trichomegaly in a woman with metastatic rectal carcinoma. We review the clinical presentation, adverse effects, and management of EGFR inhibitor-related eyelash trichomegaly. The long eyelashes are not a drug-limiting adverse effect and some patients consider the change to be cosmetically enhancing. Trimming the lashes with scissors can usually ameliorate local symptoms. The eyelashes often return to their original length at variable time periods after EGFR inhibitor therapy is discontinued.

Panitumumab-Related Eyelash Elongation in a Patient With Metastatic Gastrointestinal Carcinoma

“…EFGR inhibitors may function as a monoclonal antibody, acting in the extracellular medium as panitumumab, or in the intracellular medium as tyrosine-kinase inhibitors. 7 EFGR inhibitors have been associated with side-effects such as hypertrichosis, alopecia, and changes in hair pigmentation, growth, and texture. These effects are not as common as skin manifestations.…”

“…These effects are not as common as skin manifestations. 7 The severity of skin eruptions may be ameliorated with skin care, topical antibiotics, immunomodulating agents, prophylactic use of tetracyclin and minocyclin, avoiding dose reduction, or discontinuation of drug treatment. 4,5 In contrast, eyelash trichomegaly is not a drug-limiting adverse effect nor does it interfere with drug action.…”

“…Furthermore, this adverse reaction has been perceived by patients undergoing oncology treatment with monoclonal antibodies against EGFR, such as cetuximabe or panitumumab. 7 These drugs inhibit EGFR, which is expressed on hair follicle epithelium. Therefore, it is believed that trichomegaly is attributable to EGFR inhibition, leading to premature maturation of epithelial cells of the hair follicle, resulting in deregulated gene expression of keratin.…”

Afatinib-Associated Cutaneous Toxicity: A Correlation of Severe Skin Reaction with Dramatic Tumor Response in a Woman with Exon 19 Deletion Positive Non-Small-Cell Lung Cancer

“…Ranges of cutaneous toxicity from clinical studies of afatinib are shown in Table 1 [ 9 ]. Hypertrichosis has also been described in some individuals who have been treated with EGFR inhibitors [ 6 - 7 ].…”

Intrinsic caspase-8 activation mediates sensitization of erlotinib-resistant tumor cells to erlotinib/cell-cycle inhibitors combination treatment

“…9, 10, 11 These therapeutic agents have an established role in treating non-small cell lung, colorectal, pancreatic, breast and head and neck cancers, and erlotinib in particular has been approved by the FDA. 9, 12 However, resistance to erlotinib has also been described, particularly in breast cancer cell lines, 13 and FDA alerts highlighted cases of hepatic failure, gastrointestinal perforation and ocular disorders 14 as a result of erlotinib treatment. These non-desirable side effects may be ameliorated by decreasing the dosage used.…”