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Targeted Therapy- and Chemotherapy-Associated Skin Toxicities: Systematic Review and Meta-Analysis
Jingyi Ding1, Magdoleen H Farah1, Tarek Nayfeh1
1Mayo Clinic.
Problem Identification:
Preventing and managing skin toxicities can minimize treatment disruptions and improve well-being. This systematic review aimed to evaluate the effectiveness of interventions for the prevention and management of cancer treatment-related skin toxicities.
Literature Search:
The authors systematically searched for comparative studies published before April 1, 2019. Study selection and appraisal were conducted by pairs of independent reviewers.
Data Evaluation:
The random-effects model was used to conduct meta-analysis when appropriate.
Synthesis:
39 studies (6,006 patients) were included; 16 of those provided data for meta-analysis. Prophylactic minocycline reduced the development of all-grade and grade 1 acneform rash in patients who received erlotinib. Prophylaxis with pyridoxine 400 mg in capecitabine-treated patients lowered the risk of grade 2 or 3 hand-foot syndrome. Several treatments for hand-foot skin reaction suggested benefit in heterogeneous studies. Scalp cooling significantly reduced the risk for severe hair loss or total alopecia associated with chemotherapy.
Implications For Research:
Certainty in the available evidence was limited for several interventions, suggesting the need for future research.
Supplemental Material Can Be Found At&Nbsp;Https:
//onf.ons.org/supplementary-material-targeted-therapy-and-chemotherapy-associated-skin-toxicity-systematic-review.
Insights
Effective interventions like minocycline for acneform rash, pyridoxine for hand-foot syndrome, and scalp cooling for hair loss can manage cancer treatment skin toxicities. Further research is needed due to limited evidence certainty for some methods.
Area of Science:
- Oncology
- Dermatology
- Evidence-Based Medicine
Background:
- Cancer treatments, including targeted therapy and chemotherapy, frequently cause skin toxicities.
- These toxicities can lead to treatment interruptions and negatively impact patient well-being.
- Effective prevention and management strategies are crucial for patient care.
Purpose of the Study:
- To systematically review and evaluate the effectiveness of interventions for preventing and managing cancer treatment-related skin toxicities.
- To synthesize evidence from comparative studies to inform clinical practice.
Main Methods:
- A systematic literature search was conducted for comparative studies published before April 1, 2019.
- Study selection and appraisal were performed by two independent reviewers.
- Meta-analysis was employed using a random-effects model where appropriate.
Main Results:
- Sixteen of 39 included studies (6,006 patients) provided data for meta-analysis.
- Prophylactic minocycline reduced acneform rash in erlotinib recipients.
- Pyridoxine prophylaxis lowered hand-foot syndrome risk in capecitabine-treated patients.
- Scalp cooling significantly reduced severe hair loss and alopecia from chemotherapy.
Conclusions:
- Certain interventions show promise for managing specific cancer treatment-related skin toxicities.
- Evidence certainty for several interventions is limited, highlighting the need for further high-quality research.
- Optimizing supportive care for skin toxicities can improve treatment adherence and patient quality of life.
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