Evaluation of a Comprehensive Skin Toxicity Program for Patients Treated With Epidermal Growth Factor Receptor Inhibitors at a Cancer Treatment Center
Cohort study (n= 208) found adherence to prophylaxis protocols for cutaneous epidermal growth factor receptor inhibitor (EGFRi) associated toxicity significantly improved over time and was linked to decreased need for rescue treatments and lower incidence of EGFRi dose changes.
Source:
JAMA Dermatology
SPS commentary:
Researchers note that up to 90% patients treated with epidermal growth factor receptor inhibitor (EGFRi) experience cutaneous toxic effects. In their analysis, of 118 patients treated with cetuximab in 2012 and 90 patients treated with cetuximab in 2017, they found that patients prescribed prophylactic treatment were 94% less likely to require a first rescue treatment for rash (OR 0.06; 95% CI, 0.02-0.16; p<0 .001), 74% less likely to require a second rescue treatment for rash (0.26;, 0.08-0.83; p =0 .02), and 79% less likely to experience a cetuximab dose change or interruption (0.21; 0.06-0.81; p= 0.02) than patients not prescribed prophylactic treatment, which coincided with the integration of dermatologic care into traditional oncology care.
According to an editorial, timely and consistent access to dermatologic expertise in oncology practices is critical to prevent unnecessary discontinuation of life-saving anticancer therapy, especially as multiple studies have demonstrated that anticancer therapy–associated skin toxicity may be associated with a positive response to anticancer therapy. It adds that close dermatologic care and involvement have also been shown to be associated with earlier detection and management of secondary cancers due to long-term anticancer therapy. This collaborative working may thus improve the quality of life and health outcomes of patients with cancer.