Pre-emptive skin toxicity treatment for anti-EGFR drugs: evaluation of efficacy of skin moisturizers and lymecycline. A phase II study

Grande, Roberta; Narducci, Filomena; Bianchetti, Sara; Mansueto, Giovanni; Gemma, Donatello; Sperduti, Isabella; Trombetta, Giorgio; Angelini, Franco; Gamucci, Teresa

doi:10.1007/s00520-012-1715-1

Cited by 17 publications

(13 citation statements)

References 19 publications

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“…In 1 study, after preemptive treatment, only 3 patients of 51 reported a moderate effect of skin toxicity on their overall quality of life, as measured using the mDLQI. 89 Similarly, the results from the STEPP trial indicated a reduced mean mDLQI score for patients who received preemptive treatment for dermatologic toxicity compared with those receiving reactive treatment, indicating that reducing the appearance of early skin reactions could have a significant effect on patient perceptions and morale. 30…”

Section: Reviewmentioning

confidence: 98%

Dermatologic Toxicity Occurring During Anti-EGFR Monoclonal Inhibitor Therapy in Patients With Metastatic Colorectal Cancer: A Systematic Review

Lacouture

Anadkat

Jatoi

et al. 2018

Clinical Colorectal Cancer

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Monoclonal antibody inhibitors of the epidermal growth factor receptor (EGFR) have been shown to improve outcomes for patients with metastatic colorectal cancer (mCRC) without RAS gene mutations. However, treatment with anti-EGFR agents can be associated with toxicities of the skin, nails, hair, and eyes. Because these dermatologic toxicities can result in treatment discontinuation and affect patient quality of life, their management is an important focus when administering anti-EGFR monoclonal antibodies. The present systematic review describes the current data reporting the nature and incidence of, and management and treatment options for, dermatologic toxicities occurring during anti-EGFR treatment of mCRC. A search of the National Library of Medicine PubMed database from January 1, 2009, to August 18, 2016, identified relevant reports discussing dermatologic toxicity management among patients with mCRC receiving anti-EGFR therapy. The studies were grouped by type and rated by level of evidence using the GRADE approach developed by the Agency for Healthcare Research and Quality. Overall, 269 reports were reviewed (nonrandomized trials, n = 120; randomized trials, n = 31; retrospective studies, n = 15; reviews, n = 39). Dermatologic toxicity of any grade occurs in most patients who receive anti-EGFR therapy; approximately 10% to 20% of patients experienced grade 3/4 toxicity. The most common dermatologic toxicities include papulopustular/acneiform rash, xerosis, and pruritus; however, nail changes, hair abnormalities, and ocular conditions also occur. Guidance for managing these toxicities includes the use of inexpensive emollient ointments and moisturizers, avoidance of sun exposure, avoidance of irritants, and the use of short showers. Several studies also found that preemptive treatment was more effective than reactive treatment at limiting the incidence and severity of skin toxicity. With appropriate treatment, the dermatologic toxicities associated with anti-EGFR monoclonal antibody therapy can be managed, minimizing patient discomfort and the need for therapy interruption and/or discontinuation. Additionally, preemptive treatment can reduce dermatologic toxicity severity, ultimately yielding better quality of life.

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Section: Reviewmentioning

confidence: 98%

Dermatologic Toxicity Occurring During Anti-EGFR Monoclonal Inhibitor Therapy in Patients With Metastatic Colorectal Cancer: A Systematic Review

Lacouture

Anadkat

Jatoi

et al. 2018

Clinical Colorectal Cancer

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“…Jatoi et al, 39 comparing 2 groups of patients treated with anti-EGFR agents (mostly cetuximab) in combination with tetracyclines or placebo, reported the same rate of skin reactions and no difference in QoL. Grande et al, 40 however, evaluating preemptive lymecycline in a phase II study, obtained gratifying results: 27% G2 and no G3 or G4 skin reactions in patients treated with anti-EGFR agents (59% cetuximab).…”

Section: Antibiotic Prophylaxismentioning

confidence: 92%

“…[27][28][29][30][31][32][33][34][35]52,53 Early data on antibiotic prophylaxis also indicate a positive role of tetracyclines. [37][38][39][40][41] The updated Expert Opinion detailed in this article represents the second Italian consensus positions derived from best clinical practices and from the available scientific literature on the treatment of anti-EGFR skin reactions.…”

Section: Antibioticsmentioning

confidence: 99%

Management of Skin Reactions During Cetuximab Treatment in Association With Chemotherapy or Radiotherapy

Pinto¹,

Barone

Girolomoni

et al. 2016

American Journal of Clinical Oncology

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“…Preventive measures for acneiform rash include the use of sunscreen and sun protective behavior, (Burtness et al, 2009) and keeping the skin hydrated by using emollients and avoiding long hot showers and irritating soaps (Ouwerkerk and Boers-Doets, 2010). Several phase 2 studies have evaluated the utility of prophylactic oral tetracyclines in combination with topical steroids, sunscreen, and moisturizers for the prevention of the acneiform rash, with overall promising results that demonstrated a reduced incidence of severe rash (Belum et al, 2017, Grande et al, 2013, Kobayashi et al, 2015, Lacouture et al, 2010, Lacouture et al, 2016, Lacouture and Sibaud, 2018, Scope et al, 2007).…”

Section: Targeted Therapiesmentioning

confidence: 99%

Dermatologic conditions in women receiving systemic cancer therapy

Ferreira

Ramseier

Leventhal

2019

International Journal of Women's Dermatology

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As advances in cancer therapies have improved cancer-related survival, novel therapeutics have also introduced a variety of dermatologic toxicities, and an increased number of patients are living with these sequalae. Women with cancer in particular experience a spectrum of dermatologic conditions that affect their skin, hair, nail, and mucosal surfaces. Studies have shown that these toxic effects can significantly affect quality of life and alter a woman’s self-image, cultural identity, femininity, sexuality, and mental health. In severe instances, dermatologic toxicities may even disrupt cancer therapy and can therefore affect overall survival and treatment response. In this article, we review the dermatologic adverse effects from traditional chemotherapy, targeted therapy, immune checkpoint inhibitors, and endocrine therapy that disproportionately affect women. The timely diagnosis and management of these dermatologic conditions is crucial in the multidisciplinary care of women with cancer.

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Pre-emptive skin toxicity treatment for anti-EGFR drugs: evaluation of efficacy of skin moisturizers and lymecycline. A phase II study

Abstract: Data show efficacy of preemptive treatment with a well-tolerated profile. A reduction of severe skin toxicities is shown with an increase of grade 1 toxicities, not leading to anti-EGFR dose reduction and with better quality of life for patients.

Cited by 17 publications

References 19 publications

Dermatologic Toxicity Occurring During Anti-EGFR Monoclonal Inhibitor Therapy in Patients With Metastatic Colorectal Cancer: A Systematic Review

Dermatologic Toxicity Occurring During Anti-EGFR Monoclonal Inhibitor Therapy in Patients With Metastatic Colorectal Cancer: A Systematic Review

Management of Skin Reactions During Cetuximab Treatment in Association With Chemotherapy or Radiotherapy

Dermatologic conditions in women receiving systemic cancer therapy

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