Acneiform eruptions with combination targeted cancer therapy in colorectal cancer patients.
Acneiform Eruptions
/ chemically induced
Anti-Bacterial Agents
/ therapeutic use
B7-H1 Antigen
Colorectal Neoplasms
/ drug therapy
ErbB Receptors
Exanthema
/ chemically induced
Humans
Mitogen-Activated Protein Kinase Kinases
/ therapeutic use
Phosphatidylinositol 3-Kinases
/ therapeutic use
Programmed Cell Death 1 Receptor
Protein Kinase Inhibitors
/ adverse effects
Proto-Oncogene Proteins B-raf
/ therapeutic use
Retinoids
/ therapeutic use
Retrospective Studies
Superinfection
Tetracycline
/ therapeutic use
Acneiform eruption
BRAFI
Combination therapy
EGFRI
MEKI
PDL1
Retinoid
Tetracycline
Journal
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
ISSN: 1433-7339
Titre abrégé: Support Care Cancer
Pays: Germany
ID NLM: 9302957
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
29
04
2022
accepted:
23
06
2022
pubmed:
1
7
2022
medline:
28
9
2022
entrez:
30
6
2022
Statut:
ppublish
Résumé
Epidermal growth factor receptor inhibitors (EGFRI) can be used with pathway inhibitors, including mitogen-activated protein kinase kinase inhibitors (MEKIs), BRAF inhibitors (BRAFIs), and checkpoint inhibitors such as programmed death-ligand 1 (PD-L1) and programmed cell death protein 1 (PD-1) to treat colorectal cancer. These can precipitate treatment-resistant acneiform eruptions, prompting dose modification or discontinuation. Predicting the likelihood of severe rash development and crafting effective treatments may promote adherence to life-saving chemotherapy. An Institutional Review Board-approved retrospective chart review of patients with colorectal cancer treated with EGFRI or MEKI in combination with HER2, BRAF, PI3K, or checkpoint inhibitors between January 1, 2016, and January 1, 2020, was performed. Surrogates for rash severity were investigated, including lower extremity involvement, utilization of oral steroids or retinoids, dose modification, and incidence of superinfection. Of 122 patients treated with combination therapy, 105 developed a rash, and 87 developed an acneiform eruption. Common combinations included MEKI/PD-LI, EGFRI/MEKI, and MEKI/PD-1I. Patients treated with EGFRI/MEKI developed the most severe rashes (p = 0.02). Lower extremity involvement was more frequent with EGFRI/MEKI compared to alternative combinations (p = 0.05). Drug holiday correlated with all rash severity surrogates, including rash grade, lower extremity involvement, oral steroid or retinoid use, and incidence of superinfection. Use of oral steroids or retinoids was associated with development of superinfection (p = 0.002). Prophylactic tetracycline use did not impact rash severity or rash incidence. This is the first descriptive analysis to characterize acneiform eruptions for patients with colorectal cancer on combination cancer therapy. Approximately 85% of patients developed a cutaneous toxicity with what appears to be synergistic effects of EGFRI and MEKI combination therapy causing the most severe eruptions. Superinfection rate correlated to systemic therapy use beyond oral tetracyclines. Further investigation into the utility of prophylactic oral tetracyclines in this population is needed.
Identifiants
pubmed: 35771289
doi: 10.1007/s00520-022-07257-2
pii: 10.1007/s00520-022-07257-2
doi:
Substances chimiques
Anti-Bacterial Agents
0
B7-H1 Antigen
0
Programmed Cell Death 1 Receptor
0
Protein Kinase Inhibitors
0
Retinoids
0
ErbB Receptors
EC 2.7.10.1
Proto-Oncogene Proteins B-raf
EC 2.7.11.1
Mitogen-Activated Protein Kinase Kinases
EC 2.7.12.2
Tetracycline
F8VB5M810T
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
8051-8058Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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