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Diverse landscape of dermatologic toxicities from small-molecule inhibitor cancer therapy

Riyad N H Seervai1,2,3, Woo Cheal Cho4, Emily Y Chu5

  • 1Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas, USA.

Journal of Cutaneous Pathology
|October 8, 2021
PubMed
Abstract

Insights

Small-molecule inhibitors (Nibs) effectively treat cancer but cause diverse skin toxicities. Recognizing these varied and overlapping dermatologic side effects is crucial for patient care in oncodermatology.

Area of Science:

  • Oncology
  • Dermatology
  • Pharmacology

Background:

  • Molecular biology and genetics drive targeted cancer therapies.
  • Small-molecule inhibitors (Nibs) target specific cancer pathways.
  • Nibs are associated with significant dermatologic toxicities.

Purpose of the Study:

  • To review and categorize dermatologic toxicities associated with various classes of Nibs.
  • To analyze clinical trial data and literature on Nib-induced skin reactions.

Main Methods:

  • Comprehensive review of dermatologic toxicities from Nibs.
  • Categorization into five pathway groups: MAPK, growth factor/multi-tyrosine kinase, cell division/DNA repair, myeloproliferative neoplasms signaling, and other signaling pathways.
  • Inclusion of prospective clinical trials (Phase I-III), retrospective reviews, meta-analyses, and case reports.

Main Results:

  • Dermatologic toxicities span all Nib classes, ranging from mild to life-threatening.
  • Common toxicities include inflammatory reactions (maculopapular, acneiform, eczematous lesions).
  • Squamous cell carcinoma with keratoacanthoma-like features observed with some Nibs; significant overlap in toxicities across Nib classes.

Conclusions:

  • Nib-induced dermatologic toxicities are diverse and can overlap between different Nib classes.
  • Early recognition of these varied skin toxicities is essential for effective patient management.
  • This knowledge is critical for the growing field of oncodermatology and dermatopathology.
Keywords:
dermatologic toxicitiessmall-molecule inhibitorstargeted cancer therapy

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