Physiological Change in Cutaneous Toxicity Related to Epidermal Growth Factor Receptor (EGFR) Inhibitors and the Efficacy of Emollient

剛士, 中原; 洋一, 師井; 浩一, 高山; 洋一, 中西; 増隆, 古江

doi:10.2336/nishinihonhifu.76.242

Cited by 4 publications

(4 citation statements)

References 9 publications

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Section: Cq3 Are Moisturizers Useful For Treating Asteatosis Related ...mentioning

confidence: 96%

“…Indeed, as one of physiological changes related to EGFR inhibitor‐induced skin toxicities, the stratum corneum water content decreased early after the start of administration 101 . According to other studies, the application of moisturizers increased the stratum corneum water content, relieving skin symptoms 101–103 . These studies suggest that the early application of moisturizers is useful for relieving asteatosis related to molecular‐targeted drugs, although there is little evidence.…”

Section: Cq3 Are Moisturizers Useful For Treating Asteatosis Related ...mentioning

confidence: 99%

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English version of guidelines for the management of asteatosis 2021 in Japan

Saeki

Tsunemi

Arai

et al. 2021

The Journal of Dermatology

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This is the English version of guidelines for the management of asteatosis 2021 in Japan. Asteatosis is a synonym of xerosis found in a wide range of diseases that induce dry skin through impaired functions of either water retention of the stratum corneum or skin covering with acid mantle. Patients with asteatosis may be accompanied by pruritus. Moisturizers are the first‐line treatment for asteatosis and their adequate use must be recommended. The main purpose of the present guidelines is to define skin symptoms requiring treatment with moisturizers for medical use in patients with asteatosis. If the deterioration of marked scaling or scratch marks is predicted, therapeutic intervention with moisturizers for medical use should be considered even in the absence of pruritus. Regarding six important points requiring decision‐making in clinical practice (clinical questions), we evaluated the balance between the benefits and harm of medical interventions in reference to previous reports of clinical research, and presented the recommendation grades and evidence levels to optimize the patient outcome by medical interventions.

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Section: Cq3 Are Moisturizers Useful For Treating Asteatosis Related ...mentioning

confidence: 96%

Section: Cq3 Are Moisturizers Useful For Treating Asteatosis Related ...mentioning

confidence: 99%

English version of guidelines for the management of asteatosis 2021 in Japan

Saeki

Tsunemi

Arai

et al. 2021

The Journal of Dermatology

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“…Of the cutaneous toxicities, which are a major side-effect of EGFR inhibitors, dryness can be alleviated or prevented by using moisturizers. Medical moisturizers, including preparations that contain heparin-like compounds, are widely used [5][6][7] , but many patients complain about the sticky feeling associated with using these medical moisturizers, and if the use of moisturizers is to continue, moisturizers that match patients' preferences are required. This study aimed to investigate the treatment of cutaneous toxicities caused by EGFR inhibitors by comparing patients who used a cosmetic moisturizer, namely, NOV ® skin cream D (Noevir Co., Ltd., Kobe, Japan), with those who used conventional medical moisturizers.…”

Section: Introductionmentioning

confidence: 99%

Epidermal Growth Factor Inhibitor-induced Cutaneous Toxicity Improves with Moisturizers

Morino¹,

Okuno²,

Hirakawa³

et al. 2020

Trends Immunother

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Although epidermal growth factor receptor (EGFR) inhibitors are one of the most effective treatment options for lung cancer, they frequently cause cutaneous toxicity that can lead to treatment discontinuation. Dryness, which is a common form of cutaneous toxicity, is usually treated using medical moisturizing agents. We aimed to investigate the treatment of cutaneous toxicity caused by EGFR inhibitors by comparing patients who used a cosmetic moisturizer with those who used conventional medical moisturizers. This study included 12 patients with lung cancer, who were receiving EGFR inhibitors and using topical medical moisturizers. The participants were assigned to a group that continued using medical moisturizers or a group that began using NOV® skin cream D. The study’s findings showed that like conventional medical moisturizers, NOV®skin cream D improved the cutaneous dryness caused by EGFR inhibitors and that it might additionally improve patients’ quality of life. Also, we obtained novel findings that NOV® skin cream D normalized keratinization, which is a component of normal skin cell differentiation impeded by EGFR inhibitors. Hence, the cosmetic moisturizer may help to prevent the discontinuation of EGFR inhibitors, thereby ensuring their continuous therapeutic effects.

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“…There have been limited studies on skin changes from EGFRI evaluated by biophysical measurements. [9][10][11] In the present study, we evaluated the EGFRI-derived skin changes by non-invasive instrumental measurements on various sites of the body, especially the predilection sites of AfE (e.g. cheek) and xerosis and fissure (i.e.…”

Section: Introductionmentioning

confidence: 99%

Instrumental evaluation sensitively detects subclinical skin changes by the epidermal growth factor receptor inhibitors and risk factors for severe acneiform eruption

Kikuchi

Nozawa

Yamazaki

et al. 2018

The Journal of Dermatology

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Epidermal growth factor receptor inhibitors (EGFRI), EGFR tyrosine kinase inhibitors (TKI) and anti‐EGFR antibodies commonly develop skin toxicities including acneiform eruption (AfE). However, precise skin changes and risk factors for severe AfE are still unclear. The objective of the current study was elucidation of the useful parameters for early and sensitive detection of the skin changes by EGFRI. Transepidermal water loss (TEWL), skin surface hydration, skin surface lipid levels and erythema/melanin index were serially measured for 2 weeks in 19 EGFR‐TKI afatinib/erlotinib‐treated patients and for 8 weeks in 20 anti‐EGFR antibody cetuximab‐treated patients. The TEWL levels of the cheek in the patients who developed AfE of grade 2 and more (AfE ≥ Gr2) were already elevated at 7 days after the initiation of afatinib/erlotinib therapy compared with those before therapy as well as in patients with grade 1 or less (AfE ≤ Gr1). In patients treated with cetuximab, the skin surface hydration on the cheek in AfE ≥ Gr2 patients significantly decreased compared with that of AfE ≤ Gr1 patients at the 2nd and 6th week. Baseline skin surface lipid levels and erythema index on the cheek of patients with AfE ≥ Gr2 were significantly higher than those with AfE ≤ Gr1. The small sample size of the present study, especially for logistic regression analysis, is a limitation. In conclusion, instrumental evaluation declared rapid inflammatory changes of the skin by EGFRI and elucidated oily skin as a risk for severe AfE.

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Physiological Change in Cutaneous Toxicity Related to Epidermal Growth Factor Receptor (EGFR) Inhibitors and the Efficacy of Emollient

Cited by 4 publications

References 9 publications

English version of guidelines for the management of asteatosis 2021 in Japan

English version of guidelines for the management of asteatosis 2021 in Japan

Epidermal Growth Factor Inhibitor-induced Cutaneous Toxicity Improves with Moisturizers

Instrumental evaluation sensitively detects subclinical skin changes by the epidermal growth factor receptor inhibitors and risk factors for severe acneiform eruption

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