Search for Evidence-Based Approaches for the Prevention and Palliation of Hand–Foot Skin Reaction (HFSR) Caused by the Multikinase Inhibitors (MKIs)

Anderson, Roger T.; Jatoi, Aminah; Robert, Caroline; Wood, Laura S.; Keating, Karen; Lacouture, Mario E.

doi:10.1634/theoncologist.2008-0237

Cited by 100 publications

(74 citation statements)

References 38 publications

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“…Health care staff should frequently examine patients and encourage them to discuss any skin concerns to ensure early diagnosis of skin toxicities, particularly within the first 2 months of therapy. Table 5 shows the standardized NCI-CTCAE version 4.0 grading for dermatologic toxicities, which may be helpful in guiding treatment decisions [11,17,18,25]. However, these criteria were not developed specifically for skin symptoms associated with targeted therapies.…”

Section: Preventionmentioning

confidence: 99%

Optimizing Treatment Outcomes With Regorafenib: Personalized Dosing and Other Strategies to Support Patient Care

et al. 2014

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Regorafenib is an oral multikinase inhibitor that inhibits several kinases relevant to tumor biology in several cancers, including colorectal carcinoma (CRC) and gastrointestinal stromal tumor (GIST). In phase III trials, regorafenib significantly improved overall survival versus placebo in patients with metastatic CRC progressing after all available standard therapies, and significantly prolonged progression-free survival in patients with advanced GIST in whom at least imatinib and sunitinib had failed. Thus, this agent holds promise as a new standard of care for CRC and GIST patients after disease progression following all other approved therapies.The clinical trials reported to date show that this new treatment has a consistent adverse event profile that is quite different from that of traditional cytotoxic chemotherapies. The most common adverse events of regorafenib include dermatologic and mucosal toxicities (especially hand-foot skin reaction, rash, and oral mucositis), constitutional symptoms (e.g., fatigue, nausea, and weight loss), vascular effects (especially hypertension), and gastrointestinal symptoms (e.g., diarrhea). To help health care professionals anticipate and manage the adverse events associated with regorafenib, we describe our experiences in clinical trials and show that such toxicities can be effectively managed with close observation of patients from initiation of dosing, along with prompt appropriate interventions, including dose modifications, if necessary. The Oncologist 2014;19:669-680 Implications for Practice: Regorafenib is a novel oral agent with documented efficacy in advanced colorectal cancer. It has a characteristic adverse event profile that consists of hand-foot skin reaction, fatigue, diarrhea, hypertension, and other less common events. This article details practical management strategies of these adverse events to optimize patient care and maximize the clinical benefit patients can derive from this novel agent.

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Section: Preventionmentioning

confidence: 99%

Optimizing Treatment Outcomes With Regorafenib: Personalized Dosing and Other Strategies to Support Patient Care

et al. 2014

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“…We developed a self-care scale on the basis of previous studies [15] [16] [18]. Content validity of the resulting questionnaire was confirmed by specialists in oncology and dermatology.…”

Section: Measurement Of Self-care For Hand-foot Syndromementioning

confidence: 99%

Relationship between Self-Care and Hand Foot Syndrome Specific Quality of Life in Cancer Patients

Mikoshiba¹,

Yamamoto‐Mitani²,

Sato³

et al. 2016

OJN

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Purpose: The purpose of this study was to describe adherence to self-care for hand-foot syndrome (HFS) and the relationship between self-care and health-related quality of life (QOL). Methods: A cross-sectional study was conducted on 105 consecutive outpatients with HFS. To assess self-care for HFS and QOL, the participants were asked to complete self-care and HFS-14 (hand-foot syndrome specific QOL) questionnaires, respectively. Multiple regression models were used to identify the relationship between self-care and QOL. Results: Adherence to self-care for HFS was low, less than 50% for most of the items. Multivariate analysis revealed that poorer self-care (βs = −0.19; P = 0.03), depressive symptoms (βs = 0.43; P < 0.0001), and being employed (βs = 0.20; P = 0.04) were independent predictors of poorer QOL scores. Conclusions: We have identified a need for further research to develop effective programs of self-care in HFS.

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Section: Supportive Carementioning

confidence: 99%

“…Before sorafenib treatment begins, a qualified health care professional should conduct a baseline skin check for predisposing factors [33,61,63]. Hyperkeratotic areas or calluses should be removed via pedicure or manicure [33,61,63]. Feet and hands should be examined for areas under excessive friction or undue stress, and cushioning these areas is recommended [33,63].…”

Section: Supportive Carementioning

confidence: 99%

“…Hyperkeratotic areas or calluses should be removed via pedicure or manicure [33,61,63]. Feet and hands should be examined for areas under excessive friction or undue stress, and cushioning these areas is recommended [33,63]. Although anecdotal evidence suggests that prophylactic pyridoxine (vitamin B 6 ) is beneficial for preventing HFSR [63], studies found pyridoxine to be ineffective for managing capecitabine-induced HFS [64].…”

Section: Supportive Carementioning

confidence: 99%

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Clinical Presentation and Management of Hand–Foot Skin Reaction Associated with Sorafenib in Combination with Cytotoxic Chemotherapy: Experience in Breast Cancer

Gómez

Lacouture

2011

The Oncologist

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Current combination therapies for advanced breast cancer provide a modest survival benefit but with greater toxicity than with monotherapies. New combinations are needed that improve the efficacy of current treatments and have acceptable tolerability profiles. Recent clinical trials have assessed the efficacy and safety of the multikinase inhibitor sorafenib in combination with common treatments for advanced breast cancer. Sorafenib has both antiangiogenic and antiproliferative activities and is indicated for patients with unresectable hepatocellular and advanced renal cell carcinoma. Generally, sorafenib is associated with manageable, non-life-threatening adverse events. One of the more common adverse events seen with sorafenib is handfoot skin reaction, a dermatologic toxicity usually localized to the pressure points of the palms and soles. Although hand-foot skin reaction is reversible and not life threatening, it can have a significant impact on a patient's quality of life and may necessitate dose modification. Moreover, sorafenib is being evaluated in combination with breast cancer treatments that are associated with a similar dermatologic toxicity (e.g., capecitabine-induced hand-foot syndrome). This review looks at the use of sorafenib in combination with selected chemotherapies in patients with advanced breast cancer and considers the incidence, prevention, and management of hand-foot skin reaction. The Oncologist 2011;16:1508 -1519

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Search for Evidence-Based Approaches for the Prevention and Palliation of Hand–Foot Skin Reaction (HFSR) Caused by the Multikinase Inhibitors (MKIs)

Cited by 100 publications

References 38 publications

Optimizing Treatment Outcomes With Regorafenib: Personalized Dosing and Other Strategies to Support Patient Care

Optimizing Treatment Outcomes With Regorafenib: Personalized Dosing and Other Strategies to Support Patient Care

Relationship between Self-Care and Hand Foot Syndrome Specific Quality of Life in Cancer Patients

Clinical Presentation and Management of Hand–Foot Skin Reaction Associated with Sorafenib in Combination with Cytotoxic Chemotherapy: Experience in Breast Cancer

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