Epidermal Growth Factor Receptor Inhibitor–Associated Cutaneous Toxicities: An Evolving Paradigm in Clinical Management

Epidermal growth factor receptor inhibitors (EGFRIs) have demonstrated improved overall survival in patients with non‐small cell lung cancer, pancreatic cancer, and colorectal cancer; however, their use is associated with dermatologic reactions of varying severity. The similar spectrum of events obs...

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Bibliographic Details
Published in:The oncologist (Dayton, Ohio) Ohio), 2007-05, Vol.12 (5), p.610-621
Main Authors: Lynch, Thomas J., Kim, Ed S., Eaby, Beth, Garey, Jody, West, Dennis P., Lacouture, Mario E.
Format: Article
Language:English
Subjects:
Antibodies, Monoclonal - adverse effects
Antineoplastic Agents - adverse effects
Cetuximab
Cutaneous toxicity
Drug Eruptions - epidemiology
Drug Eruptions - etiology
Drug Eruptions - pathology
Drug Eruptions - therapy
EGFR
Erlotinib
Exanthema - chemically induced
Exanthema - epidemiology
Exanthema - pathology
Exanthema - therapy
Humans
Incidence
Neoplasms - drug therapy
Panitumumab
Pathobiology Forum Consensus
Protein Kinase Inhibitors - adverse effects
Receptor, Epidermal Growth Factor - antagonists & inhibitors
Severity of Illness Index
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Summary:Epidermal growth factor receptor inhibitors (EGFRIs) have demonstrated improved overall survival in patients with non‐small cell lung cancer, pancreatic cancer, and colorectal cancer; however, their use is associated with dermatologic reactions of varying severity. The similar spectrum of events observed with monoclonal antibodies and tyrosine kinase inhibitors suggests such toxicities are a class effect. While such reactions do not necessarily require any alteration in EGFRI treatment, being best addressed through symptomatic treatment, there is limited evidence on which to base such therapies. In October 2006, at an international and interdisciplinary EGFRI dermatologic toxicity forum, the underlying mechanisms of these toxicities were discussed and commonly used therapeutic interventions were evaluated. Our aim was to reach a current consensus on management strategies. A three‐tiered, EGFRI‐focused toxicity grading system is suggested for the purposes of therapeutic decision making, and as a framework on which to build a stepwise approach to intervention. This approach to successful management is specifically tailored to accurately categorize dermatologic toxicity associated with EGFRIs, and can be easily applied by all health care professionals. The goal is to maximize quality of life in patients who are being treated with these agents—many of whom will be on these drugs for several months or even years. Disclosure of potential conflicts of interest is found at the end of this article.
ISSN:1083-7159
1549-490X
DOI:10.1634/theoncologist.12-5-610