Analysis of the effects of vitamin K1 cream on cetuximab-induced acne-like rash.

Pilot Clinical Trial on the Efficacy of Prophylactic Use of Vitamin K1–Based Cream (Vigorskin) to Prevent Cetuximab-Induced Skin Rash in Patients With Metastatic Colorectal Cancer

“…The distribution of the rash was in agreement with the data from the first experience at the authors' institution, 39 and the incidence of grade 3 rash was at the lower limit of what has been reported in the literature (see Table 1 and Table 2) and was in agreement with previous data about the prophylactic use of vitamin K 1 ebased cream. 33,37 Data about the proportion of patients experiencing grade 2 toxicity are scarce in the literature; however, the NCI CO17 trial reported 37.2% grade 2 toxicity 4 ; in the present study, among patients using vitamin K 1 ebased cream as prophylaxis, this rate was reduced to 25%, suggesting a possible benefit of this cream mainly in reducing moderate rash.…”

“…Overall, the maximum grade of skin toxicity during the first 8 weeks of treatment, according to CTCAE version 3.0, was grade 33 20, H&N, CRC Cet, Pani K 1 , 0.05%-0.1% P 75% grade 1, 25% grade 2; no effects on coagulation Ocvirk and Cencelj (2010) 34 4, CRC Cet K 1 , 0.1% P 3 moderate rash, 1 mild rash; rapid Ocvirk (2009), ASCO 35 69, CRC Cet K 1 , 0.1% T Median time to improvement 8 days; downstaging of rash by 1 grade by 18 days Pinto (2011), ASCO-GI 36 33, H&N, CRC, EG Cet, Pani K 1 , 0.1% T Decrease in skin rash in 37%; good symptom control in 69% Radovics (2010) 37 120, H&N, CRC Cet Vitamin K Prevents Cetuximab-Induced Rash 0, grade 1, grade 2, and grade 3 in, respectively, 6 (15%), 18 (45%), 10 (25%), and 6 (15%) of the patients; no grade 4 CISR has been reported. Overall, 4 patients reported itching, 3 of them having grade 3 skin rash.…”

“…According to the literature, the cream containing 0.01% vitamin K 1 , when applied twice daily as prophylaxis during the whole treatment with cetuximab, seems to reduce the proportion of patients with grade 3 rash to nearly 10% of patients, 37 with a good tolerance as reported from patients 37 and no significant side effect on coagulation. 33 In this study's population, 82.9% of the patients experienced CISR, specifically acneiform inflammatory follicular rash, mainly on the face and trunk, within the first 8 weeks of treatment (see Fig.…”

Vitamin K1 photo‐induced reaction during treatment with cetuximab

“…2,3 Several reports have shown that topical vitamin K 1 cream may be useful in the treatment or prevention of cetuximab-related acneiform rash. [4][5][6] However, data from comparative clinical studies addressing the efficacy of vitamin K 1 cream in the management of cetuximab skin toxicity are limited. Cetuximab skin toxicity was considered as a differential diagnosis, but excluded because of the different clinical features F I G U R E 1 Erythematous itching vesicular eruption on photoexposed areas of the face and time of onset (the toxicity rash usually starts after a few weeks of therapy).…”

Management of Skin Reactions During Cetuximab Treatment in Association With Chemotherapy or Radiotherapy

“…These include vitamin K, and in particular vitamin K1 (fillochinone) and K3 (menadione). [27][28][29][30][31][32][33][34][35]52,53 Early data on antibiotic prophylaxis also indicate a positive role of tetracyclines. [37][38][39][40][41] The updated Expert Opinion detailed in this article represents the second Italian consensus positions derived from best clinical practices and from the available scientific literature on the treatment of anti-EGFR skin reactions.…”