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Skin Barrier Dysfunction, Antimicrobial Peptide Alterations, and Microbiome Changes in Solid Cancer Patients Treated

Naraporn Somboonna1,2, Patcharapong Rujirawan3, Tiwanun Promvaranon3

  • 1Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand.

Dermatology (Basel, Switzerland)
|June 5, 2026
PubMed
Abstract

Insights

Epidermal growth factor receptor inhibitors (EGFRIs) compromise skin barrier function, increasing water loss and pH. This study found EGFRIs alter antimicrobial peptides and skin microbiota in cancer patients.

Area of Science:

  • Oncology
  • Dermatology
  • Microbiology

Background:

  • Epidermal growth factor receptor inhibitors (EGFRIs) are crucial targeted therapies for various solid cancers.
  • EGFRIs are known to cause cutaneous adverse events (cAEs), impacting skin health.
  • Understanding these cAEs involves examining skin barrier function, antimicrobial peptides (AMPs), and the skin microbiome.

Purpose of the Study:

  • To investigate the incidence of cAEs in patients treated with EGFRIs.
  • To analyze changes in skin biophysical properties, AMP levels, and skin microbiome composition during EGFRIs therapy.
  • To correlate these changes with the efficacy and safety of EGFRIs in cancer treatment.

Main Methods:

  • A 2-year prospective cohort study involving patients receiving EGFRIs for solid cancers.
  • Measurement of skin biophysical parameters (TEWL, pH, elasticity, sebum, pigmentation) at baseline and up to 48 weeks.
  • Assessment of AMPs (hBD-3, RNase-7) and skin microbiome via 16S rRNA sequencing on cheek swabs at specified intervals.

Main Results:

  • A high cumulative incidence of cAEs (94.05%) was observed in patients undergoing EGFRIs treatment.
  • Significant increases in transepidermal water loss (TEWL) and skin pH, alongside decreased pigmentation, were noted.
  • A reduction in ribonuclease (RNase)-7 levels and an increase in Corynebacterium kroppenstedtii were observed in the skin microbiome.

Conclusions:

  • EGFRIs treatment significantly impairs skin barrier function and reduces AMP production.
  • Alterations in the skin microbiome composition are associated with EGFRIs therapy.
  • These findings highlight the complex dermatological impact of EGFRIs, necessitating further investigation into management strategies.
Keywords:
AlopeciaAntimicrobial peptidesEpidermal growth factor receptor inhibitorsHypertrichosisMicrobiomeMucositisPapulopustular eruptionParonychiaSkin drynessTrichomegaly

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