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Pre-emptive skin toxicity treatment for anti-EGFR drugs: evaluation of efficacy of skin moisturizers and lymecycline. A phase II study.
MedLine Citation:
PMID:  23314653     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Anti-epidermal growth factor receptor (EGFR) target therapies like erlotinib for metastatic lung cancer and cetuximab or panitumumab for metastatic colorectal cancer (mCRC) cause skin reaction that seems to be related to treatment efficacy. Skin toxicity evaluation protocol with panitumumab study has shown that preemptive treatment reduces the incidence of ≥Grade 2 (G2) skin toxicity in mCRC treated with panitumumab. Aim of this study is to evaluate if preemptive skin toxicity treatment with different drugs has good efficacy in patients receiving anti-EGFR therapies, such as cetuximab, panitumumab, and erlotinib, for mCRC and metastatic lung cancer. METHODS: Treatment included skin moisturizers with sunscreen and lymecycline 300 mg/daily. Primary objective is to reduce the incidence of ≥G2 skin toxicity during the first 3 months of therapy. Toxicities are reported with confidence interval at 95 %. Quality of life was assessed with Dermatology Life Quality Index every 2 weeks and evaluated with repeated measure ANOVA. RESULTS: Fifty-one patients with mCRC (60.8 %) and metastatic lung cancer (39.2 %) were enrolled. Anticancer drugs were erlotinib/cetuximab/panitumumab 20:30:1. At 3-month evaluation, 27.4 % patients had =G2 skin toxicity. Skin toxicity was not related with age (p = 0.67), sex (p = 0.65), previous chemotherapy regimens (p = 0.41), and current anti-EGFR treatment (p = 0.22). No gastrointestinal or hematological toxicities related to lymecycline were observed. Only six patients required further drugs. Quality of life analysis did not show a significant difference from the beginning and the end of treatment. CONCLUSIONS: Data show efficacy of preemptive treatment with a well-tolerated profile. A reduction of severe skin toxicities is shown with an increase of grade 1 toxicities, not leading to anti-EGFR dose reduction and with better quality of life for patients.
Authors:
Roberta Grande; Filomena Narducci; Sara Bianchetti; Giovanni Mansueto; Donatello Gemma; Isabella Sperduti; Giorgio Trombetta; Franco Angelini; Teresa Gamucci
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-13
Journal Detail:
Title:  Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer     Volume:  -     ISSN:  1433-7339     ISO Abbreviation:  Support Care Cancer     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9302957     Medline TA:  Support Care Cancer     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Medical Oncology Unit, ASL Frosinone, Frosinone, Italy, robertagrande@virgilio.it.
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