A proposed EGFR inhibitor dermatologic adverse event-specific grading scale from the MASCC skin toxicity study group

Lacouture, Mario E.; Maitland, Michael L.; Segaert, Siegfried; Setser, Ann; Baran, Robert; Fox, Lindy P.; Epstein, Joel B.; Barasch, Andrei; Einhorn, Lawrence H.; Wagner, Lynne I.; West, Dennis P.; Rapoport, Bernardo; Kris, Mark G.; Basch, Ethan; Eaby, Beth; Kurtin, Sandra; Olsen, Elise A.; Chen, Alice; Dancey, Janet; Trotti, Andy

doi:10.1007/s00520-009-0744-x

Cited by 135 publications

(81 citation statements)

References 23 publications

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“…The standard grading systems for adverse events need to be updated to include the new toxicities as well as reconsidering the grading of the old toxicities. Work by the Multinational Association for Supportive Care in Cancer on the new skin toxicity scale is a good example of how this can be done [79]. Work on capturing symptom data using wireless computer technology and patient-reported outcomes, with real-time review by clinicians to tailor treatment, is progressing and is likely to be extremely useful in this setting [80].…”

Section: Impact Of Tats On Clinical Practicementioning

confidence: 99%

Noncardiac Vascular Toxicities of Vascular Endothelial Growth Factor Inhibitors in Advanced Cancer: A Review

et al. 2011

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Summary. The introduction of molecularly targeted anticancer therapies has brought the promise of longer survival times for select patients with cancers previously considered untreatable. However, it has also brought new toxicities that require understanding and management, sometimes for long periods of time. Vascular endothelial growth factor inhibitors are associated with a broad range of adverse effects, with vascular toxicity being particularly serious. This review focuses on the current understanding of the pathophysiology and mechanisms of macrovascular toxicities (hypertension, hemorrhage, and thromboembolism), their incidence and severity, the current clinical management, and implications in the advanced cancer setting. Movement of these agents into the early disease setting will alter the impact of these toxicities.Search Strategy and Selection Criteria. Information for this review was collected by searching PubMed/ Medline and American Society of Clinical Oncology abstract databases. The medical subject heading terms used included toxicity, hypertension, thromboembolism, hemorrhage, intestinal perforation, risk factors, pharmacokinetics, and metabolism, combined with free text search terms including, but not limited to, VEGF inhibitor*, bevacizumab, sunitinib, and sorafenib. Articles published in English before March 2010 were included, in addition to information from case reports and pharmaceutical agent package inserts. The Oncologist 2011;16:432-444

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Section: Impact Of Tats On Clinical Practicementioning

confidence: 99%

Noncardiac Vascular Toxicities of Vascular Endothelial Growth Factor Inhibitors in Advanced Cancer: A Review

et al. 2011

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“…Together, these observations underscore the importance of a multidisciplinary approach toward the management of treatment-related AEs. Efforts are under way to improve upon the detection and reporting of skin-related and other AEs associated with EGFR inhibition [83].…”

Section: Safety and Tolerabilitymentioning

confidence: 99%

Balancing Safety and Efficacy of Epidermal Growth Factor Receptor Inhibitors in Patients With Squamous Cell Carcinoma of the Head and Neck

Iberri

Colevas

2015

The Oncologist

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The epidermal growth factor receptor (EGFR) is overexpressed in more than 80% of squamous cell cancers of the head and neck (SCCHN). An evolving understanding of the role of EGFR in tumorigenesis has made the receptor an important therapeutic target in SCCHN. Several EGFR inhibitors (EGFRIs) are active in SCCHN, and their use is associated with improvement in progression-free survival and overall survival in various treatment settings. Nevertheless, EGFR inhibition is associated with significant mucocutaneous toxicity that must be balanced against its anticipated efficacy. This review summarizes the relevant clinical trial experience with EGFRIs, with attention to efficacy, toxicity, and methods of selecting patients most likely to benefit from therapy.

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“…The proposed scale has the same terminology and grading principles as CTCAE version 4.0. However, it includes more specific descriptors of given conditions and patient-reported health-related quality of life factors [7].…”

Section: Discussionmentioning

confidence: 99%

“…Physical examination showed diffuse erythema, edema of the eyes and face, as well as the perifollicular pustules and papules with impetiginization. The diagnosed papulopustular rash was classified as grade 2 according to the National Cancer Institute's Common Terminology Criteria for Adverse Events version 4.03, and by the use of MASCC (Multinational Association of Supportive Care in Cancer) scale as grade 2 as well [7].…”

Section: Case Reportmentioning

confidence: 99%

Effective therapy of epidermal growth factor receptor inhibitor-associated dermatologic side effects in a patient with metastatic colorectal cancer: a and review of literature

Góralczyk¹,

Sokołowska‐Wojdyło²,

Kowalczyk³

et al. 2012

pdia

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A Ad dd dr re es ss s f fo or r c co or re es ss sp po on nd de en nc ce e: : Alicja Góralczyk, Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, 7 Dębinki, Poland, phone Case report A b s t r a c tOverexpression and impaired signaling of the epidermal growth factor receptor (EGFR) are involved in the cancerogenesis. The EGFR inhibitors such as cetuximab have shown efficacy in the targeted therapy of neoplasm. The acneiform rash has been revealed as the most common side effect of treatment, usually occurring within 2 weeks after therapy onset. We report perifollicular pustules and papules with impetiginization in a 63-year-old patient with metastatic colorectal cancer treated with cetuximab. The neoplasm was diagnosed in 2008 and treated surgically (resection of the sigmoid). After 3 years, a combined therapy was administered due to the disease progression. It consisted of cetuximab and FOLFOX (Folinic acid, Fluorouracil, Oxaliplatin) chemotherapy regimen. The effective dermatologic management (with systemic doxycycline and topical tacrolimus and fusidic acid) of the skin toxicity allowed for maintenance of oncologic treatment. Despite the proper dermatological therapy, the described side effects may persist, and the exacerbation of skin lesions can cause discontinuation of treatment of cancer with those modern biological agents (EGFR inhibitors and other kinase inhibitors). When discontinuation is not necessary -cutaneous symptoms adversely affect the quality of life. However, there are reports that recognition of the skin lesions in the course of the above therapies is a good prognostic factor, confirming effectiveness of treatment. Moreover, the association between genetic polymorphisms, the risk of treatment adverse effects and the response of the tumor to monoclonal antibody targeted therapy is well established. This leads to the increasing role of pharmacogenetics in the management of neoplasms. K Ke ey y w wo or rd ds s: : epidermal growth factor receptor inhibitors, cetuximab, dermatologic toxicity, papulopustular rash.

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A proposed EGFR inhibitor dermatologic adverse event-specific grading scale from the MASCC skin toxicity study group

Cited by 135 publications

References 23 publications

Noncardiac Vascular Toxicities of Vascular Endothelial Growth Factor Inhibitors in Advanced Cancer: A Review

Noncardiac Vascular Toxicities of Vascular Endothelial Growth Factor Inhibitors in Advanced Cancer: A Review

Balancing Safety and Efficacy of Epidermal Growth Factor Receptor Inhibitors in Patients With Squamous Cell Carcinoma of the Head and Neck

Effective therapy of epidermal growth factor receptor inhibitor-associated dermatologic side effects in a patient with metastatic colorectal cancer: a and review of literature

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