A prospective, randomized, double-blinded, split-face/chest study of prophylactic topical dapsone 5% gel versus moisturizer for the prevention of cetuximab-induced acneiform rash

Belum, Viswanath Reddy; Marchetti, Michael A.; Dusza, Stephen W.; Cercek, Andrea; Kemeny, Nancy E.; Lacouture, Mario E.

doi:10.1016/j.jaad.2017.03.039

Cited by 13 publications

(9 citation statements)

References 4 publications

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“…As predicted in 2015 and in 2016 [34,35], dapsone was shown to ameliorate anti-epidermal growth factor receptor mediated rash in 2017 [39,40], a rash mediated by VEGF containing neutrophils drawn to rash areas by IL-8 during erlotinib or cetuximab treatment but countered by dapsone. We therefore expect dapsone to augment bevacizumab by reducing neutrophil borne VEGF to glioblastomas.…”

Section: Dapsonesupporting

confidence: 53%

Paths for Improving Bevacizumab Available in 2018: The ADZT Regimen for Better Glioblastoma Treatment

Kast¹

2018

Preprint

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During glioblastoma treatment, the pharmaceutical monoclonal antibody to VEGF, bevacizumab, has improved quality of life and delayed progression for several months but has not, or only marginally prolonged overall survival. In 2017 several dramatic research papers appeared that are crucial to our understanding of glioblastoma vis a vis the mode of action of bevacizumab. As a consequence of these papers, a new, potentially more effective, treatment protocol can be built around bevacizumab. This is the ADZT Regimen where four old drugs are added to bevacizumab. These four are apremilast, marketed to treat psoriasis, dapsone, marketed to treat Hansen’s disease, zonisamide, marketed to treat seizures, and telmisartan, marketed to treat hypertension. The ancillary attributes of each of these drugs has been shown to augment bevacizumab. This paper will detail the research data supporting that contention.

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Section: Dapsonesupporting

confidence: 53%

Paths for Improving Bevacizumab Available in 2018: The ADZT Regimen for Better Glioblastoma Treatment

Kast¹

2018

Preprint

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“…Similar results were observed in dacomitinib-treated patients given oral doxycycline [ 12 ]. Prophylaxis with topical dapsone gel also seems to be a promising treatment [ 13 ]. Prescription of antibiotics upon initiation of EGFRIs or MEKIs should be recommended in cancer patients as well as the bacterial culture being performed when secondary infection is suspected to determine the strain involved.…”

Section: Skin Toxicitiesmentioning

confidence: 99%

Toxic Side Effects of Targeted Therapies and Immunotherapies Affecting the Skin, Oral Mucosa, Hair, and Nails

2018

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Targeted therapies and immunotherapies are associated with a wide range of dermatologic adverse events (dAEs) resulting from common signaling pathways involved in malignant behavior and normal homeostatic functions of the epidermis and dermis. Dermatologic toxicities include damage to the skin, oral mucosa, hair, and nails. Acneiform rash is the most common dAE, observed in 25–85% of patients treated by epidermal growth factor receptor and mitogen-activated protein kinase kinase inhibitors. BRAF inhibitors mostly induce secondary skin tumors, squamous cell carcinoma and keratoacanthomas, changes in pre-existing pigmented lesions, as well as hand-foot skin reactions and maculopapular hypersensitivity-like rash. Immune checkpoint inhibitors (ICIs) most frequently induce nonspecific maculopapular rash, but also eczema-like or psoriatic lesions, lichenoid dermatitis, xerosis, and pruritus. Of the oral mucosal toxicities observed with targeted therapies, oral mucositis is the most frequent with mammalian target of rapamycin (mTOR) inhibitors, followed by stomatitis associated to multikinase angiogenesis and HER inhibitors, geographic tongue, oral hyperkeratotic lesions, lichenoid reactions, and hyperpigmentation. ICIs typically induce oral lichenoid reactions and xerostomia. Targeted therapies and endocrine therapy also commonly induce alopecia, although this is still underreported with the latter. Finally, targeted therapies may damage nail folds, with paronychia and periungual pyogenic granuloma distinct from chemotherapy-induced lesions. Mild onycholysis, brittle nails, and a slower nail growth rate may also be observed. Targeted therapies and immunotherapies often profoundly diminish patients’ quality of life, which impacts treatment outcomes. Close collaboration between dermatologists and oncologists is therefore essential.

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“…As predicted in 2015 and in 2016 [27,28], dapsone was shown to an ameliorate anti-epidermal growth factor receptor mediated rash in 2017 [32,33], a rash mediated by VEGF containing neutrophils drawn to rash areas by IL-8 during erlotinib or cetuximab treatment, but countered by dapsone. We therefore expect dapsone to augment bevacizumab by reducing neutrophil borne VEGF in glioblastomas.…”

Section: Dapsonementioning

confidence: 78%

Paths for Improving Bevacizumab Available in 2018: The ADZT Regimen for Better Glioblastoma Treatment

Kast¹

2018

Medical Sciences

View full text Add to dashboard Cite

During glioblastoma treatment, the pharmaceutical monoclonal antibody to vascular endothelial growth factor A, bevacizumab, has improved the quality of life and delayed progression for several months, but has not (or only marginally) prolonged overall survival. In 2017, several dramatic research papers appeared that are crucial to our understanding of glioblastoma vis-a-vis the mode of action of bevacizumab. As a consequence of these papers, a new, potentially more effective treatment protocol can be built around bevacizumab. This is the ADZT regimen, where four old drugs are added to bevacizumab. These four drugs are apremilast, marketed to treat psoriasis, dapsone, marketed to treat Hansen’s disease, zonisamide, marketed to treat seizures, and telmisartan, marketed to treat hypertension. The ancillary attributes of each of these drugs have been shown to augment bevacizumab. This paper details the research data supporting this contention. Phase three testing of AZDT addition to bevacizumab is required to establish safety and effectiveness before general use.

show abstract

A prospective, randomized, double-blinded, split-face/chest study of prophylactic topical dapsone 5% gel versus moisturizer for the prevention of cetuximab-induced acneiform rash

Cited by 13 publications

References 4 publications

Paths for Improving Bevacizumab Available in 2018: The ADZT Regimen for Better Glioblastoma Treatment

Paths for Improving Bevacizumab Available in 2018: The ADZT Regimen for Better Glioblastoma Treatment

Toxic Side Effects of Targeted Therapies and Immunotherapies Affecting the Skin, Oral Mucosa, Hair, and Nails

Paths for Improving Bevacizumab Available in 2018: The ADZT Regimen for Better Glioblastoma Treatment

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