Recommendations on management of EGFR inhibitor-induced skin toxicity: a systematic review.

Advances in the understanding of the mechanisms involved in oncogenesis have led to the development of so-called targeted therapies such as epidermal growth factor receptor (EGFR) inhibitors, which take on an increasingly important role in the management of cancer These treatments have the advantage not to trigger the adverse effects traditionally encountered with chemotherapy, such as nausea, vomiting or haematological toxicity However, they do cause new forms of toxicity: the most common one is skin toxicity It is important to be aware of it because it can be debilitating, adversely impacting patients’ quality of life and altering treatment compliance, although it appears to be correlated with treatment response in certain series Non-specialists can have difficulty in recognising this unusual skin toxicity The dermatologic side effects most frequently triggered by EGFR inhibitors are discussed in this article They are divided into three categories depending on their target: inflammation of the pilo-sebaceous follicle, represented by EGFR inhibitor-associated folliculitis, which occurs at an early stage and is frequent; alteration in the skin barrier, primarily responsible for xerosis, fissures and pruritus, which are frequent and delayed; and lesions of the skin appendages (paronychia, pyogenic granuloma, hair changes), which are delayed and less frequent It is essential for all practitioners concerned to know about these dermatologic side effects in order to ensure better global management of patients, particularly in terms of quality of life

Semiology of skin toxicity associated with epidermal growth factor receptor (EGFR) inhibitors

In the past decade, the expanded use of targeted anticancer drugs has significantly prolonged survival in patients treated for a variety of cancers. Despite their increased specificity, agents such as epidermal growth factor receptor inhibitors (EGFRIs), BRAF inhibitors, and targeted immunotherapies have commonly been associated with a number of dermatologic adverse events, often necessitating treatment modifications and negatively impacting patients' quality of life. Although toxicities such as rash and xerosis are frequently discussed, symptomatic pruritus, or itch, has emerged as an important, and frequently neglected, event. The present study reviews the incidence and clinical presentation of pruritus with the EFGRIs, and with two novel anti-melanoma drugs, vemurafenib and ipilimumab, with a focus on the putative underlying pathophysiology, and current management strategies.

Pruritus to anticancer agents targeting the EGFR, BRAF, and CTLA-4.

The role of anti-epidermal growth factor receptor monoclonal antibody monotherapy in the treatment of metastatic colorectal cancer.

Biologic agents designed as targeted therapy are at the forefront of research in the field of colorectal cancer. Monoclonal antibodies targeting the epidermal growth factor receptor (EGFR) represent one such form of treatment, and the novel agent panitumumab is the first fully-human monoclonal antibody developed in this class. This drug is generally well-tolerated, with skin toxicities similar to those associated with other EGFR inhibitor therapies as the primary adverse effect. Efficacy has been evaluated in multiple settings, and panitumumab has demonstrated significant therapeutic effect both as monotherapy, as well as part of first- and second-line combination chemotherapy regimens. Panitumumab has also played a pivotal role in establishing the importance of biomarker science in the field of colorectal cancer and the whole of oncology. Studies demonstrating lack of therapeutic response to the agent in the setting of KRAS mutation led to the first indication of an agent based on genetic characteristics. Current and ongoing studies will continue to define panitumumab and determine its role in the treatment of colorectal cancer. This review will present background information on this therapeutic agent and explore present and future directions.

Metastatic Colorectal Cancer: Focus on Panitumumab

e20634 Background: Skin toxicity that can impact quality of life as well as treatment adherence is commonly associated with EGFR therapy. Despite their particular importance in terms of making decisions regarding supportive care, time to onset and maximum grade of skin toxicity are seldom reported. Pmab is a fully human monoclonal antibody directed against the EGFR with demonstrated monotherapy activity in patients (pts) with wild-type KRAS expressing, chemotherapy refractory, mCRC. Methods: In this single-arm study, first-line pts with histologically confirmed mCRC were enrolled to receive pmab (6mg/kg) and FOLFIRI every 2 weeks. This trial is ongoing to evaluate the primary endpoint of objective response rate and secondary endpoints including disease control rate, duration of response, time to response, progression-free survival, time to progression and other safety aspects. The focus of this abstract is skin toxicity. Results: Cutoff for the initial interim analysis was 27 June 2008. Of the 154 pts enr...

Epidermal growth factor receptor (EGFR) inhibitor-related skin toxicity: Review of interim data from a phase II study (20060314) of panitumumab (pmab) with FOLFIRI in the first-line treatment of metastatic colorectal cancer (mCRC)

4085 Background: The fully human anti-epidermal growth factor receptor monoclonal antibody pmab, has proven monotherapy activity in chemotherapy refractory mCRC pts with wild-type KRAS-expressing t...

Updated analysis of a phase II study (20060314) of panitumumab (pmab) with FOLFIRI as first-line treatment of patients (pts) with metastatic colorectal cancer (mCRC)

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Epidermal growth factor receptor (EGFR) inhibitor-related skin toxicity: Review of interim data from a phase II study (20060314) of panitumumab (pmab) with FOLFIRI in the first-line treatment of metastatic colorectal cancer (mCRC)

Updated analysis of a phase II study (20060314) of panitumumab (pmab) with FOLFIRI as first-line treatment of patients (pts) with metastatic colorectal cancer (mCRC)