Current Recommendations and Novel Strategies for the Management of Skin Toxicities Related to Anti-EGFR Therapies in Patients with Metastatic Colorectal Cancer

Maria Carmela Annunziata, Alfonso De Stefano, Gabriella Fabbrocini, Silvana Leo, Paolo Marchetti, Maria Concetta Romano, Ivana Romano

Research output: Contribution to journalReview article

Abstract

The use of targeted therapies, when added to conventional chemotherapy, has significantly improved clinical outcomes and survival of cancer patients. While targeted therapies do not have the systemic adverse reactions of chemotherapy, they are associated with toxicities that can be severe and impair patient quality of life and adherence to anti-cancer treatment. Panitumumab and cetuximab, two monoclonal antibodies against epidermal growth factor receptor (EGFR), are recommended for the treatment of metastatic colorectal cancer (mCRC). The majority of patients with mCRC who are treated with anti-EGFR therapy develop skin toxicities, including papulopustular rash (the most common), xerosis, painful cracks and fissures on the palms and soles of the feet, paronychia, pruritus, and abnormal hair and eyelash growth; they are also more prone to skin infections. Given the involvement of EGFR in normal epidermis physiology, development and function, skin toxicities caused by anti-EGFR therapy are not unexpected. In recent years, recommendations have been formulated for the prevention and treatment of anti-EGFR therapy-related skin toxicities. Indeed, proper and timely management of these toxicities is important for ensuring uninterrupted anti-cancer treatment and optimal outcomes. Here, we review the current knowledge of anti-EGFR therapy-related skin toxicities and the latest recommendations for their management. We also present a treatment approach for papulopustular rash based on the combination of fusidic acid plus betamethasone in a lipid-enriched topical formulation. The effectiveness of this approach is documented by the presentation of five cases successfully treated in clinical practice for anti-EGFR therapy-related rash.

Original languageEnglish
JournalClinical Drug Investigation
DOIs
Publication statusPublished - 2019

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Epidermal Growth Factor Receptor
Colorectal Neoplasms
Skin
Exanthema
Therapeutics
Paronychia
Eyelashes
Fusidic Acid
Drug Therapy
Betamethasone
Neoplasms
Pruritus
Epidermis
Hair
Foot
Monoclonal Antibodies
Quality of Life
Lipids
Survival

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Current Recommendations and Novel Strategies for the Management of Skin Toxicities Related to Anti-EGFR Therapies in Patients with Metastatic Colorectal Cancer. / Annunziata, Maria Carmela; De Stefano, Alfonso; Fabbrocini, Gabriella; Leo, Silvana; Marchetti, Paolo; Romano, Maria Concetta; Romano, Ivana.

In: Clinical Drug Investigation, 2019.

Research output: Contribution to journalReview article

Annunziata, Maria Carmela ; De Stefano, Alfonso ; Fabbrocini, Gabriella ; Leo, Silvana ; Marchetti, Paolo ; Romano, Maria Concetta ; Romano, Ivana. / Current Recommendations and Novel Strategies for the Management of Skin Toxicities Related to Anti-EGFR Therapies in Patients with Metastatic Colorectal Cancer. In: Clinical Drug Investigation. 2019.
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