Targeting the epidermal growth factor receptor in solid tumors: focus on safety

Inhibition of the EGFR has emerged as a promising anticancer strategy, offering improved efficacy and quality of life for patients affected by tumors. The overall level of toxicity associated with EGFR inhibitors is low compared to other chemotherapy drugs, although they are commonly associated with skin and gastrointestinal adverse events. Thus, patients' quality of life may be considerably affected both by a physical and a psychosocial perspective. Adverse events that lead to treatment interruption or cessation may significantly compromise their outcome.

This review summarizes the characteristics of the distinctive toxicities of drugs targeting EGFR, addressing their incidence, pathophysiology and clinical presentation with a focus on the management of skin rash and other relevant adverse events, according to the available clinical evidence. Data regarding the correlation between the development of skin rash and clinical outcome are also reported.

Drugs targeting EGFR are associated with a lower overall incidence of systemic side effects compared to standard chemotherapeutic agents; nevertheless, an increased risk of distinct toxicities that may affect patient's quality of life and anticancer treatment compliance is observed. Thus, clinical training projects directed toward a more accurate knowledge of such adverse events are essential to maximize the progress of targeted therapies against cancer.