Predictive Value of Early Skin Rash in Cetuximab-Based Therapy of Advanced Biliary Tract Cancer

Rubovszky, Gábor; Budai, Barna; Ganofszky, Erna; Horváth, Zsolt; Juhos, É; Madaras, Balázs; Nagy, Tünde; Szabó, Eszter; Pintér, Tamás; Tóth, Erika; Láng, István; Hitre, Erika

doi:10.1007/s12253-017-0238-y

Cited by 6 publications

(5 citation statements)

References 32 publications

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“…Rashes are often reported in patients treated with tyrosine kinase inhibitors (TKIs) in for a variety of cancers. Often the rash has been associated with more favorable disease outcomes and this includes lapatinib in HER2 positive breast cancer [8][9][10]. Our series was too small to determine whether infectious complications had any prognostic significance.…”

Section: Discussionmentioning

confidence: 93%

Characterization of infections and hypogammaglobulinemia treated with the combination of pertuzumab and trastuzumab

Mortimer

Kruper

Jung

et al. 2019

Cancer Chemother Pharmacol

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Purpose We update a patient series that reported a high incidence of infection with Gram-positive cocci in women treated with the combination of pertuzumab and trastuzumab and further characterize this clinical problem. Patients Treating physicians and advanced practice partners identified women who developed infections while on treatment with pertuzumab and trastuzumab alone or in combination with chemotherapy and enrolled them onto this registry trial. Results Between March, 2014 and May, 2017, 48 patients with HER2-positive breast cancers were reported to have 59 individual infections. The median age was 48 years. Twenty-four patients received neoadjuvant therapy, 17 were treated for metastatic disease, and 7 were treated in the adjuvant setting. Pertuzumab and trastuzumab were combined with carboplatin and docetaxel in 24 (49%) patients, docetaxel in 10 (21%), nab-paclitaxel in 12 (24%), and without other agents in 2 (4%). Granulocyte growth factors were administered in 24 (49%) patients and no patients were documented to be neutropenic. Folliculitis developed in 25 (52%) patients and was counted as a single infection. Abscesses developed at a number of sites in 24 (49%) patients, including a septic knee requiring total knee replacement. Paronychia occurred in 7 (15%) patients, and 5 (10%) developed cellulitis. When cultures were obtained, Gram-positive cocci were consistently identified. Hypogammaglobulinemia was documented in 14 (36%) of the 33 patients tested. Conclusions Our data continue to support an increased risk of infections with Gram-positive cocci as a potentially serious adverse event in women treated with pertuzumab and trastuzumab.

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Section: Discussionmentioning

confidence: 93%

Characterization of infections and hypogammaglobulinemia treated with the combination of pertuzumab and trastuzumab

Mortimer

Kruper

Jung

et al. 2019

Cancer Chemother Pharmacol

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“…It is suggested that early skin rash can be used as a bio-marker to select patients who would benefit from the treatment with cetuximab plus chemotherapy. 5 However, skin rash may cause significant physical and psycho-social discomfort. 6 Despite of the prophylactic use of tetracycline, there are still a high percentage of patients who suffer from grade 2 skin toxicities 6,7 .…”

Section: Resultsmentioning

confidence: 99%

A case of unexpected peripherally inserted central catheter removal from a colorectal cancer patient with cetuximab-induced skin toxicity and contact dermatitis at the peripherally inserted central catheter insertion site: Should we recommend the patient to choose subcutaneous port preferentially?

Wang

2020

J Vasc Access

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Introduction: Obtaining central venous access is one of the most commonly performed procedures in cancer patients. However, there are very limited data to guide clinicians when selecting a device for metastatic colorectal cancer patients who received cetuximab. Case description: A 54-year-old male patient with metastatic colorectal cancer treated with cetuximab plus FOLFIRI used peripherally inserted central catheter as intravenous pathway. After eight cycles, the patient suffered cetuximab-induced grade 2 skin toxicity and grade 3 contact dermatitis at the peripherally inserted central catheter insertion site. Finally, he removed the peripherally inserted central catheter and accepted subcutaneous port instead for 2 years without implantation cutaneous complication. Conclusions: We suggest that metastatic colorectal cancer patients treated with cetuximab should be recommended to choose subcutaneous port preferentially to avoid potential risk of unexpected peripherally inserted central catheter removal due to cetuximab-induced skin toxicity or contact dermatitis. Further clinical practices and researches are needed for more profound evidences for better practical suggestions.

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“…AEs have potential in predicting survival with certain targeted drugs. For example, it has been reported that rash is able to predict the survival benefit of cetuximab for metastatic colorectal cancer; 24 diarrhea has a valuable role in assessing the efficacy of sorafenib in patients with advanced hepatocellular carcinoma. 25 Hence, the association between diarrhea and pyrotinib effectiveness or patient outcome was explored in this study, and a negative correlation between diarrhea and pyrotinib efficacy was found.…”

Section: Discussionmentioning

confidence: 99%

Real-World Outcome and Prognostic Factors Among HER2-Positive Metastatic Breast Cancer Patients Receiving Pyrotinib-Based Therapy: A Multicenter Retrospective Analysis

Liu¹,

Sun²,

Du³

et al. 2022

BCTT

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To explore the efficacy, safety, and potential factors influencing efficacy and outcome of pyrotinib-based therapy in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) in complex clinical practice. Methods: Real-world data for HER2-positive MBC patients treated with pyrotinib-based regimens from 6 hospitals in Northern Anhui, China, from September 2018 to February 2022, were retrospectively collected, and clinicopathological features, efficacy, prognosis, and safety were analyzed. Potential influencing factors including baseline serum vascular endothelial growth factor-A (VEGF-A) for evaluating pyrotinib's treatment response and outcome were also explored. Results: A total of 169 patients with HER2-positive MBC were enrolled. The objective response rate (ORR), disease control rate (DCR), and median progression-free survival (mPFS) of the overall cohort were 65.1%, 87.6%, and 12.4 months, respectively. Pyrotinib is highly beneficial as different treatment lines and appears to be a feasible strategy both in combination with chemotherapeutic drugs and alone. The mPFS values were 16.5 months, 12.4 months, and 9.3 months in the first, second, and third-or-higher lines of anti-HER2 therapy, respectively (P=0.027). The most common adverse event (AE) was diarrhea (88.2%), and patients with < grade 3 diarrhea achieved a longer mPFS than patients with ≥ grade 3 diarrhea (13.3 months vs 6.9 months, P=0.007). Among the patients with available baseline VEGF-A data, the ORR was 43.5% in patients with a high level of VEGF-A, compared to 81.5% in patients with a low level of VEGF-A (P=0.005). Moreover, patients in the VEGF-A-high group exhibited a shorter mPFS time than those in the VEGF-A-low group (7.8 months vs 19.1 months, P=0.004). Further analysis demonstrated AE of diarrhea and VEGF-A at baseline to be independent prognostic factors for PFS. Conclusion: Pyrotinib-based regimens showed promising efficacy, with manageable tolerance, and AE occurrence of severe diarrhea and baseline level of serum VEGF-A are helpful in predicting the treatment outcome of pyrotinib in HER2-positive MBC.

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Predictive Value of Early Skin Rash in Cetuximab-Based Therapy of Advanced Biliary Tract Cancer

Cited by 6 publications

References 32 publications

Characterization of infections and hypogammaglobulinemia treated with the combination of pertuzumab and trastuzumab

Characterization of infections and hypogammaglobulinemia treated with the combination of pertuzumab and trastuzumab

A case of unexpected peripherally inserted central catheter removal from a colorectal cancer patient with cetuximab-induced skin toxicity and contact dermatitis at the peripherally inserted central catheter insertion site: Should we recommend the patient to choose subcutaneous port preferentially?

Real-World Outcome and Prognostic Factors Among HER2-Positive Metastatic Breast Cancer Patients Receiving Pyrotinib-Based Therapy: A Multicenter Retrospective Analysis

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