Cutaneous Side Effects and Transepidermal Water Loss To Gefitinib: A Study of 11 Patients

Chandra, Franky; Sandiono, Dendi; Sugiri, Unwati; Suwarsa, Oki; Gunawan, Hendra

doi:10.1007/s13555-016-0163-0

Cited by 9 publications

(5 citation statements)

References 29 publications

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“…The risk of skin dryness during treatment increases with age, pre-eczema, and prior cytotoxic use. Evidence showed patients who received gefitinib experienced xerosis cutis, acneiform have mean Transepidermal Water Loss values higher than normal (46). The different degrees of severity of the xerosis are illustrated in Figure 2.…”

Section: Xerosismentioning

confidence: 99%

Update review of skin adverse events during treatment of lung cancer and colorectal carcinoma with epidermal growth receptor factor inhibitors

Peng

Zhang

et al. 2018

BST

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The past decades have witnessed a rapid increase in the use of molecularly targeted therapies. One class of agents includes the epidermal growth factor receptor inhibitors (EGFRIs), which afford patients longer progression-free survival (PFS) times, especially among non-small cell lung cancer (NSCLC) and metastatic colorectal carcinoma (mCRC). Certain adverse effects, particularly skin toxicity, are mainly manifested as rash, xerosis, pruritus, nails changes, hair changes and mucositis. Previous studies reported the adverse events occurred based on the cutaneous inflammation reaction. Treatment recommended glucocorticoids and antibiotics. It is suggested that skin toxicity is an important issue because it usually affects patients' quality of life (QoL) and still causes dose reduction or discontinuation of targeted therapies. For these reasons, more and more oncologists and dermatologists recognize the importance of recognition and management of skin toxicities with the expansion in availability of EGFRIs. In this review, we conducted a systematic review of recent data to examine the types and frequencies of dermatologic toxicities associated with anti-epidermal growth factor receptor (EGFR) therapies in NSCLC and mCRC. In addition, we would like to explore the management and treatment options currently used by clinicians based on the possible mechanism.

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Section: Xerosismentioning

confidence: 99%

Update review of skin adverse events during treatment of lung cancer and colorectal carcinoma with epidermal growth receptor factor inhibitors

Peng

Zhang

et al. 2018

BST

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“…The repeated tape stripping every 12 hours prevented full recovery of the skin barrier, which usually takes 24 hours [27,32], creating a chronically impaired skin barrier. Further, Chandra F, et al showed that EGFRI therapy causes increased transepidermal water loss (TEWL) of 11.5g/ m 2 h [33]. Although we did not measure TEWL in this study, ten tape strips have been shown to result in similar TEWL levels (e.g., 9.1g/m 2 h) [34].…”

Section: Discussionmentioning

confidence: 65%

Safety Evaluations of Topical Vitamin K1 for Epidermal Growth Factor Receptor Inhibitor-Induced Rash

Wolf¹,

Nabiee²,

Candela³

et al. 2021

J Drug Res Dev

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Papulopustular rash occurs in 80% of patients receiving Epidermal Growth Factor Receptor Inhibitor therapy for cancer. Topical vitamin K1, a phosphatase inhibitor, could reduce epidermal growth factor receptor inhibitor-induced rash. This preliminary safety study evaluated a novel topical 0.1% vitamin K1product for potential use in patients with epidermal growth factor receptor inhibitor-induced rash. Ten healthy subjects applied topical 0.1% vitamin K1 to healthy and tape stripped skin every 12 hours for five doses. Vitamin K1 levels were measured by ELISA in serum and plasma at 0, 26, and 50 hours. Vitamin K1 levels ranged between 0 to 8.22ng/ml. Bivariate correlative analyses showed no association between mean vitamin K1 concentration and time (r=0.008, p=0.930). Using a range of vitamin K1 concentrations (2.5 to 100ng/ml) that encompassed and exceeded the levels detected in our healthy subjects, we evaluated the ability of vitamin K1 to reverse cetixumab-induced Epidermal Growth Factor Receptor inhibition in A549 lung cancer cells. Vitamin K1 did not significantly change phosphorylated-Epidermal Growth Factor Receptor levels in cetuximab-treated cells (p>0.670). In conclusion, systemic vitamin K1 levels up to 100ng/ml would not interfere with epidermal growth factor receptor inhibitor therapy. Our next step is to test the effectiveness of our 0.1% topical VK1 formulation for Epidermal Growth Factor Receptor Inhibitor-induced rash in patients receiving epidermal growth factor receptor inhibitor therapy in a randomized, placebo-controlled, blinded study.

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“…30 Previous study showed that patients who are taking gefitinib experienced cutaneous side effects including xerosis cutis, acneiform eruptions, and paronychia, and had mean transepidermal water loss values higher than normal. 31 In our study, we evaluated the skin water content by the skin testing instrument to illustrate the efficacy of Zizao Yangrong granules.…”

Section: Discussionmentioning

confidence: 99%

Application of Zizao Yangrong Granules for Treating Targeted Drugs–Related Skin Xerosis: A Randomized Double-Blinded Controlled Study

et al. 2020

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Background: Dermatologic toxicities are the most common side effects associated with the targeted drugs epidermal growth factor receptor inhibitors (EGFRIs), in which xerosis commonly complicated by pruritus severely disturbs the quality of life. The study has observed the curative effect of Zizao Yangrong granules (ZYG) from Chishui Xuanzhu in the treatment of EGFRIs-related xerosis and pruritus, as well as evaluating the safety of the prescription. Methods: Patients (n = 68) who had xerosis after using EGFRIs were enrolled and then randomly divided into the treatment group and control group, respectively, receiving ZYG and placebo granules combined with vitamin E ointment. The intervention lasted 4 weeks. Changes in xerosis and pruritus were observed, and blood routine examination as well as liver and kidney function are observed as safety indexes. The water content of skin and qualify of life were observed. Results: A total of 66 out of 68 patients finished the study with 34 patients in each group. The effective rates of xerosis among the treatment group and control group were 84.8% and 69.7% after 2 weeks’ treatment ( P < .05), while they were 84.8% and 75.8% after 4 weeks’ treatment ( P < .05). The patients in the experimental group had better quality of life than that in the control group ( P = .045). Conclusion: ZYG can effectively improve the skin dryness associated with EGFRIs, and significantly improve the quality of life of patients with good safety; however, larger randomized controlled trials are needed to verify these findings.

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Cutaneous Side Effects and Transepidermal Water Loss To Gefitinib: A Study of 11 Patients

Cited by 9 publications

References 29 publications

Update review of skin adverse events during treatment of lung cancer and colorectal carcinoma with epidermal growth receptor factor inhibitors

Update review of skin adverse events during treatment of lung cancer and colorectal carcinoma with epidermal growth receptor factor inhibitors

Safety Evaluations of Topical Vitamin K1 for Epidermal Growth Factor Receptor Inhibitor-Induced Rash

Application of Zizao Yangrong Granules for Treating Targeted Drugs–Related Skin Xerosis: A Randomized Double-Blinded Controlled Study

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