Isotretinoin plus clindamycin seem highly effective against severe erlotinib-induced skin rash in advanced non-small cell lung cancer

Paolo Bidoli, Diego L. Cortinovis, Ilaria Colombo, Alessandra Crippa, Federica Cicchiello, Federica Villa, Marina E. Cazzaniga, Gianfranco Altomare

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Erlotinib is useful in advanced non-small cell lung cancer although compliance and efficacy are diminished by skin rash in a high proportion of patients, often necessitating dose reduction or drug withdrawal. No effective treatment for the rash is available. Methods: We carried out a preliminary investigation on isotretinoin and clindamycin. Among 56 advanced lung cancer patients treated with erlotinib, 31 (53%) developed rash. Seven (35%) of the 20 G2/G3 cases agreed to treatment with clindamycin (450 mg/d, days 1-10; 300 mg/d, days 11-20) plus isotretinoin (20 mg/d, days 11-20) after being informed of the experimental nature of the combination. Results: In 6 of 7 (86%) patients, the rash resolved (G1/G0) without dose reduction; in the other patient (G3), the erlotinib dose also had to be reduced. Median time to resolution was 14 days (range 7-20 days). No rash-treatment adverse events occurred during 20 days of administration. Conclusions: Isotretinoin plus clindamycin promises to be the first effective treatment for erlotinib rash and is being tested further.

Original languageEnglish
Pages (from-to)1662-1663
Number of pages2
JournalJournal of Thoracic Oncology
Volume5
Issue number10
DOIs
Publication statusPublished - Oct 2010

Keywords

  • Clindamycin
  • Erlotinib
  • Isotretinoin
  • Nonsmall cell lung cancer
  • Skin rash

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

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