Toward evidence-based management of the dermatologic effects of EGFR inhibitors

Agents that inhibit epidermal growth factor receptor (EGFR) signaling are associated with dermatologic effects, primarily a papulopustular rash. These effects are generally mild-to-moderate in severity, but may negatively affect quality of life and lead to treatment delays, dose modifications, and discontinuation of therapy. These findings underscore the need for effective ways to prevent and manage the dermatologic effects of EGFR inhibitors. Evidence-based guidelines are lacking, but algorithms have been developed based on the available evidence, clinical experience, and our understanding of the effects of EGFR inhibition in skin. More recently, the first results from prospective, controlled trials specifically evaluating strategies for preventing or reducing the severity of cutaneous reactions have been reported. These reports represent the first step toward an evidence-based approach to the prevention and management of these important effects.