Dermatological adverse events with taxane chemotherapy

Abstract

Taxanes (docetaxel and paclitaxel) are among the most commonly prescribed anticancer drugs approved for the treatment of metastatic or locally advanced breast, non-small cell lung, prostate, gastric, head and neck, and ovarian cancers, as well as in the adjuvant setting for operable node-positive breast cancers. Although the true incidence of dermatological adverse events (AEs) in patients receiving taxanes is not known, and has never been prospectively analysed, they clearly represent one of the major AEs associated with these agents. With an increase in the occurrence of cutaneous AEs during treatment with novel targeted and immunological therapies when used in combination with taxanes, a thorough understanding of reactions attributable to this class is imperative. Moreover, identification and management of dermatological AEs is critical for maintaining the quality of life in cancer patients and for minimizing dose modifications of their antineoplastic regimen. This analysis represents a systematic review of the dermatological conditions reported with the use of these drugs, complemented by experience at comprehensive cancer centres. The conditions reported herein include skin, hair, and nail toxicities. Lastly, we describe the dermatological data available for the new, recently FDA-and EMA- approved, solvent-free nab-paclitaxel.

Efficacy of a global supportive skin care programme with hydrotherapy after non-metastatic breast cancer treatment: A randomised, controlled study

“…Other frequent skin toxicities included nail toxicity and hyperpigmentation, present in 76% and 79% of patients at inclusion respectively. These dAEs, which are very commonly observed after treatment with taxanes (Sibaud et al, 2016) have a negative impact on QoL, as demonstrated by an average baseline global DLQI score of 7.1 at inclusion in our total study population, which is comparable to that reported in patients with inherited ichthyosis (Bodemer et al, 2011), a skin disorder that has been described as having one of the most harmful impacts on QoL (Blanchet- Bardon, Corre, & Le, 2005).…”

“…Dermatologic adverse events (dAEs) are commonly associated with breast cancer therapies, especially with taxanes (paclitaxel and docetaxel), usually prescribed as an (neo)adjuvant chemotherapy regimen. Taxanes may lead to skin rash, nail and hair changes, flushing, hypersensitivity reactions, hand-foot and PATEO syndromes, xerosis, pigmentary changes or pruritus in the majority of patients, depending on the dose and number of cycles (Robert et al, 2015;Sibaud et al, 2016).…”

“…Several studies conducted in patients with gynaecologic cancers have identified dAEs as one of the most significant toxicities limiting quality of life (QoL) and as leading factors impairing functional, emotional, physical and social well-being in cancer patients (Gandhi, Oishi, Zubal, & Lacouture, 2010;Hackbarth, Haas, Fotopoulou, Lichtenegger, & Sehouli, 2008; Ra et al, 2013;Sibaud et al, 2016), especially because they often persist long after completion of chemotherapy (Gandhi et al, 2010).…”

CDK4/6 inhibition mitigates stem cell damage in a novel model for taxane‐induced alopecia

“…Despite these challenges and caveats, our data suggest that therapeutic cell cycle arrest approaches have the potential to prevent permanent taxane chemotherapy‐induced alopecia. Permanent chemotherapy‐induced alopecia following taxane treatment (Prevezas et al , ; Tallon et al , ; Miteva et al , ; Palamaras et al , ; Kluger et al , ; Tosti et al , ; Sibaud et al , ; Kang et al , ; Martín et al , ) is thought to arise in at‐risk individuals from irreversible stem/progenitor cell destruction and proliferative exhaustion (Paus et al , ). In this study, we show that proliferating (yet relatively slower cycling) anagen hair follicle outer root sheath keratinocytes situated within epithelial stem/progenitor cell niches (Purba et al , 2017b) are indeed susceptible to taxanes.…”

“…However, the field currently lacks a model of how taxanes, major current oncotherapeutics used to treat breast and lung cancer, damage the human hair follicle and cause chemotherapy‐induced alopecia. The need for such a model is becoming increasingly important, given the abundance of reports describing permanent taxane chemotherapy‐induced alopecia (Prevezas et al , ; Tallon et al , ; Miteva et al , ; Palamaras et al , ; Kluger et al , ; Tosti et al , ; Sibaud et al , ; Kang et al , ; Martín et al , ). This is often reported following treatment with docetaxel, which is the subject matter of on‐going lawsuits against Taxotere (docetaxel) manufacturer Sanofi (Raymond, ).…”