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Epidermal growth factor receptor inhibitors: a review of cutaneous adverse events and management

K Chanprapaph1, V Vachiramon1, P Rattanakaemakorn1

  • 1Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Rajthevi, Bangkok 10400, Thailand.

Dermatology Research and Practice
|April 12, 2014
PubMed

Insights

Epidermal growth factor inhibitors (EGFRI) treat epithelial cancers but cause skin toxicity. Prophylactic tetracycline antibiotics are the most effective management strategy for these common, yet manageable, adverse events.

Area of Science:

  • Oncology
  • Dermatology
  • Pharmacology

Background:

  • Epidermal growth factor inhibitors (EGFRI) represent a significant advancement in targeted cancer therapy for advanced epithelial cancers.
  • While offering improved efficacy and safety over traditional chemotherapy, EGFRI frequently cause cutaneous adverse events due to EGFR signaling interference in the skin.

Purpose of the Study:

  • To summarize current knowledge on the presentation and management of skin toxicities associated with EGFRI therapy.
  • To highlight the correlation between cutaneous adverse effects and therapeutic response.

Main Methods:

  • Literature review summarizing clinical presentations of EGFRI-induced dermatologic toxicities.
  • Analysis of treatment strategies, focusing on prophylactic and therapeutic interventions.

Main Results:

  • Common skin toxicities include papulopustules and xerosis; less common are paronychia, hair growth abnormalities, maculopapular rash, mucositis, and postinflammatory hyperpigmentation.
  • Radiation therapy can potentiate EGFRI-induced rashes.
  • A positive correlation exists between the severity of skin toxicity and tumor response.

Conclusions:

  • Cutaneous adverse events from EGFRI significantly impact patient compliance and quality of life.
  • Prophylactic administration of tetracycline or tetracycline-class antibiotics is the most effective current management strategy for EGFRI-related skin toxicity.

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