Preventive and Therapeutic Interventions for Anticancer Drug-induced Dermatologic Toxicities: a Scoping Review

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Anticancer drug-induced dermatologic toxicities significantly impact patient quality of life and treatment adherence.
• Current management strategies lack clear evidence patterns across different drug classes.
• Understanding the mechanisms of these toxicities is crucial for developing effective interventions.

Purpose of the Study:

• To systematically map clinical studies on preventive and therapeutic interventions for specific anticancer drug-induced dermatologic toxicities.
• To analyze evidence patterns for EGFR inhibitor-associated rash, capecitabine-induced hand-foot syndrome (HFS), and multikinase inhibitor-associated hand-foot skin reaction (HFSR).
• To utilize a mechanism- and outcome-based framework for evaluating interventions.

Main Methods:

• Conducted a scoping review of 51 clinical studies.
• Analyzed interventions for EGFR inhibitor rash, capecitabine-induced HFS, and multikinase inhibitor-associated HFSR.
• Mapped interventions based on underlying pathophysiological mechanisms and clinical outcomes.

Main Results:

• Prophylactic antibiotics and topical corticosteroids effectively reduced EGFR inhibitor rash.
• COX-2 inhibition and methylcobalamin showed efficacy in preventing capecitabine-induced HFS.
• Barrier reinforcement, COX-2 inhibition, and corticosteroids were effective for HFSR.
• Identified distinct pathophysiological profiles: inflammatory-epithelial (EGFR rash), inflammatory-neuropathic (HFS), and mechanical-vascular-inflammatory (HFSR).

Conclusions:

• Dermatologic toxicities from anticancer therapies exhibit clear mechanistic divergence.
• Toxicity-specific preventive strategies are necessary, challenging a one-size-fits-all approach.
• Mechanism-driven, toxicity-specific supportive care is the most rational and effective management strategy.