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Published on: September 11, 2015
Cutaneous toxicities of epidermal growth factor receptor inhibitors: A prospective study in 60 Asian patients
Leena Chularojanamontri1, Papapit Tuchinda1, Chayanee Likitwattananurak1
1Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Background:
Several prospective studies have been conducted in epidermal growth factor receptor (EGFR) inhibitor-related cutaneous reactions in Caucasian patients, but prospective studies in Asian populations are scarce.
Objective:
To investigate the cutaneous side effects of EGFR inhibitors in Asian cancer patients and to assess tumor response to dermatologic manifestations.
Methods:
Sixty patients with lung or colorectal cancer who were receiving EGFR inhibitors were prospectively followed for at least one year by oncologists and dermatologists.
Results:
Of 60 patients (33 males, 27 females), 46 lung cancer patients received erlotinib (n=29) and gefitinib (n=17). Cetuximab was prescribed in 14 colorectal cancer patients. Fifty-eight patients (58/60, 96.7%) developed cutaneous reactions. The most common reactions were xerosis (82.8%), acne (79.3%), and skin desquamation (62.1%). Most reactions were mild and well-tolerated. Of 14 patients who had severe reactions, temporary treatment interruption was necessary in 3 patients and a decreasing dose was required in another 3 patients. There were no statistically significant differences in type, severity, or number of cutaneous reactions between responders (29/58) and non-responders (29/58) to EGFR inhibitors. At median follow-up time of 11.92±1.08 months, no patient died from cutaneous toxicities. Nine patients died from cancer and 11 patients lost to follow-up.
Conclusion:
In this Asian population, almost all patients (96.7%) developed cutaneous toxicities of EGFR inhibitors. Xerosis, acne, and desquamation were common in Asian cancer patients. Most reactions were mild and well tolerated. Due to limited number of patients, this study did not show significant associations between cutaneous toxicities and tumor response.
Insights
Nearly all Asian cancer patients (96.7%) experienced skin side effects from epidermal growth factor receptor (EGFR) inhibitors. Common reactions like xerosis and acne were generally mild and manageable.
Area of Science:
- Oncology
- Dermatology
- Pharmacology
Background:
- Limited prospective data exists on epidermal growth factor receptor (EGFR) inhibitor-induced cutaneous reactions in Asian populations.
- Previous studies primarily focused on Caucasian patients.
Purpose of the Study:
- To prospectively investigate the spectrum of cutaneous side effects associated with EGFR inhibitors in Asian cancer patients.
- To evaluate the relationship between dermatologic manifestations and tumor response to EGFR inhibitors.
Main Methods:
- A prospective study involving 60 Asian patients with lung or colorectal cancer receiving EGFR inhibitors.
- Oncologists and dermatologists monitored patients for at least one year for cutaneous adverse events.
- Tumor response to EGFR inhibitors was assessed concurrently.
Main Results:
- 96.7% of patients developed cutaneous reactions, most commonly xerosis (82.8%), acneiform eruptions (79.3%), and desquamation (62.1%).
- The majority of reactions were mild to moderate and well-tolerated, with few requiring dose adjustments or treatment interruptions.
- No statistically significant association was found between the type, severity, or number of cutaneous reactions and tumor response to EGFR inhibitors.
Conclusions:
- Cutaneous toxicities are highly prevalent in Asian cancer patients treated with EGFR inhibitors, with xerosis, acne, and desquamation being the most frequent.
- These skin reactions are generally manageable and well-tolerated.
- The study suggests that while common, cutaneous toxicities do not appear to correlate with treatment efficacy in this patient cohort, though larger studies are needed.
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