Panitumumab Induced Forearm Panniculitis in Two Women With Metastatic Colon Cancer

Abstract

Background: Panitumumab is an EGFR inhibitor used for the treatment of metastatic colorectal cancer (mCRC), even if its use is related to skin toxicity. Case Presentation: We report the development of forearm panniculitis in two women during the treatment with Panitumumab (6 mg/Kg intravenous every 2 weeks) + FOLFOX-6 (leucovorin, 5- fluorouracil, and oxaliplatin at higher dosage) for the treatment of mCRC. Results: In both patients, clinical, laboratory and radiological evaluation documented the presence of a local panniculitis, probably related to panitumumab (Naranjo score: 6). Panatimumab discontinuation and antimicrobial + corticosteroid treatment induced a remission of skin manifestations. Conclusion: We reported for the first time the development of panniculitis during Panitumumab treatment, and we documented that the treatment with beta-lactams to either fluoroquinolones or oxazolidinone in the presence of corticosteroid improves clinical symptoms in young patients with mCRC, without the development of adverse drug reactions or drug-drug interactions.

The diverse landscape of dermatologic toxicities of non‐immune checkpoint inhibitor monoclonal antibody‐based cancer therapy

“…One patient experienced SJS after administration of cetuximab and again after treatment with panitumumab, which pointed to EGFR inhibition as the primary factor in these severe dermatologic toxicities 76 . We also found rare cases of acute generalized exanthematous pustulosis (AGEP) 19 and panniculitis 65 . Table 2 lists the dermatologic toxicities seen with mAbs targeting EGFR, including reports of the clinical aspects of dermatologic toxicities to those listed 81,83–85,228–230 …”

Epidermal Growth Factor Receptor Inhibitor Treatment Timing does not Impact Survival in Stage 4 Colon Cancer Treatment: A Retrospective Study

“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] EGFR inhibitors have shown to have severe toxicities which can influence the patient's quality of life and may affect the decision to begin treatment with these medications. 7,8, [28][29][30][31][32][33][34][35][36][37] Inferior patient outcomes of EGFR inhibitor treatment in later lines might be an important determinant for the decision to choose a different chemotherapy to avoid the risk of these toxicities and potential treatment delays. It is also important for clinicians to have justifications for the use of EGFR inhibitors in later lines.…”