Five cases of skin desquamation due to bevacizumab combined with docetaxel-carboplatin in ovarian cancer

Abstract

The standard of care for ovarian cancer chemotherapy is paclitaxel-carboplatin. In Stage III and Stage IV patients, the addition of bevacizumab has been reported to be effective, and bevacizumab combined with paclitaxel-carboplatin and bevacizumab combined with docetaxel-carboplatin are used. Patients who received bevacizumab combined with docetaxel-carboplatin experienced a high incidence of skin hardening followed by peeling. In patients treated with bevacizumab combined with docetaxel-carboplatin, we experienced a high incidence of post-sclerotic peeling of the skin, a symptom that is rarely seen with paclitaxel-carboplatin (TC), docetaxel-carboplatin (DC), or bevacizumab combined with paclitaxel-carboplatin, and has been reported in a few cases. Therefore, we investigated the actual situation of skin desquamation caused by bevacizumab combined with docetaxel-carboplatin. Thirty-one patients were included in the study, and their age (mean ± SD) was 62.9 ± 9.0. The breakdown of treatment was as follows: TC in nine patients, bevacizumab combined with paclitaxel-carboplatin in ten patients, DC in six patients, and bevacizumab combined with docetaxel-carboplatin in six patients. No number of patients with TC or bevacizumab combined with paclitaxel-carboplatin showed skin desquamation. One for DC, and five for bevacizumab combined with docetaxel-carboplatin. The five patients treated with bevacizumab combined with docetaxel-carboplatin improved with topical steroids and moisturizers, but symptoms repeatedly appeared after each course. Skin desquamation was more frequent in bevacizumab combined with docetaxel-carboplatin.

Bevacizumab-Induced Cutaneous Lupus Erythematosus in a Patient With Metastatic Colon Carcinoma: A Case Report

“…Docetaxel, an anti-microtubule class of chemotherapeutic agent, has also been reported to cause cutaneous lupus in the form of an erythematous desquamating rash during early-stage breast cancer [10]. Similarly, Tokunaga et al reported five patients with stage IIIB and IVB ovarian cancer treated with bevacizumab and a docetaxel-carboplatin combination having skin desquamation or skin hardening followed by peeling [11]. Also, Shakhbazova and Marsch reported different subtypes of lupus erythematosus, and the majority manifested as cutaneous-like reactions induced by systemic administration of drugs like 5-fluorouracil, capecitabine, and uracil-tegafur [4].…”