Cutaneous Adverse Events in Children Receiving Mitogen-Activated Protein Kinase Pathway Inhibitors

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Mitogen-activated protein kinase inhibitors (MAPKi) are vital targeted therapies for pediatric cancers.
• Cutaneous toxicities like xerosis, dermatitis, and infections are frequent side effects of MAPKi treatment.
• These skin toxicities can lead to significant patient morbidity and treatment interruptions.

Purpose of the Study:

• To investigate the incidence, spectrum, and predisposing factors of cutaneous adverse events (AE) in children treated with MAPKi.
• To document management strategies for MAPKi-associated skin toxicities.
• To propose practical skin care recommendations for caregivers to improve treatment tolerability.

Main Methods:

• An 18-month ambispective observational cohort study.
• Inclusion of 24 consecutive pediatric patients receiving MAPKi at a tertiary center.
• Prospective follow-up with retrospective data collection for ongoing therapies.

Main Results:

• A high incidence of cutaneous AE was observed, with 87.5% of patients developing at least one.
• Common AEs included xerosis, dermatitis, hair changes, paronychia, and pustular skin infections.
• Most events were low-grade (CTCAE grade 1-2), but some necessitated dose modification or treatment interruption.

Conclusions:

• Early dermatologic assessment is crucial for managing MAPKi-associated skin toxicities.
• Proactive management strategies and caregiver-directed skin care recommendations can reduce morbidity.
• Implementing these recommendations at treatment initiation can improve patient outcomes and treatment adherence.