Prophylactic strategies for hand-foot syndrome/skin reaction associated with systemic cancer treatment: a meta-analysis of randomized controlled trials

Pandy, J.G.P.; Franco, Paula Isabel G.; Li, Rubi K.

doi:10.1007/s00520-022-07175-3

Cited by 10 publications

(31 citation statements)

References 27 publications

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“…Urea was the most evaluated intervention in the studies, both in isolated use (n = 28) ( 3 , 9 , 12 – 15 , 29 , 30 , 34 , 38 – 40 , 46 – 52 , 56 – 62 ) and combined with lactic acid ( 9 , 14 , 15 , 29 , 30 , 57 , 58 ) , 5% salicylic acid ( 60 ) , and alpha hydroxy acid ( 60 ) . Various concentrations of urea were evaluated in studies, namely: 3% ( 52 ) , 10% ( 3 , 12 , 13 , 29 , 30 , 34 , 39 , 45 – 49 , 52 , 55 ) , 12% ( 12 ) , 12.5% ( 62 ) , 15% ( 56 ) , 20% ( 12 , 30 , 52 , 59 , 61 ) and 40% ( 47 , 49 , 55 , 59 – 61 ) ; however, some studies did not mention the concentration used ( 3 , 9 , 13 , 15 , 40 , 50 , 51 , 56 ) . In some studies, patients were instructed to apply urea cream twice a day ( 34 .…”

Section: Resultsmentioning

confidence: 99%

“…Several studies have been carried out to evaluate and identify interventions that are effective in preventing HFS and some systematic reviews that evaluated interventions for preventing HFS have been identified ( 3 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ) ; however, such reviews address specific interventions, such as urea-based cream, pyridoxine, and moisturizing/emollient cream. It is known, however, that other interventions have also been described in the literature for HFS prevention, such as herbal medicines, topical corticosteroids, among others; nonetheless, these interventions have not yet been analyzed by systematic reviews published to date.…”

Section: Introductionmentioning

confidence: 99%

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Topical interventions for preventing hand-foot syndrome resulting from antineoplastic therapy: A scoping review

Gialaim Purcino dos Reis,

Menêses,

Mazoni

et al. 2023

Rev. esc. enferm. USP

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Objective: To map topical interventions used to prevent hand-foot syndrome in cancer patients undergoing antineoplastic therapy. Method: This is a scoping review reported in accordance with the recommendations of PRISMA-ScR (extension for scoping review) and the Joanna Briggs Institute Manual. The searches were carried out in the electronic databases CINAHL, Cochrane CENTRAL, EMBASE, LILACS, LIVIVO, PubMed, Scopus, Web of Science; and gray literature (Google Scholar, Pro-Quest). Results: The searches resulted in 12,016 references and the final sample consisted of 45 studies. A total of 42 topical interventions were identified, including: moisturizing creams, corticosteroids, acids, mapisal, silymarin, and henna. However, urea was the most cited intervention (62%). As for the presentations of the interventions, they varied among creams, ointments, gels, hydrocolloids, decoctions, patches, powders, oils, and soaps. Conclusion: The results allowed reviewing topical interventions, with emphasis on the use of urea and moisturizing creams. However, most of the interventions identified in this review require evaluation in future studies for better understanding of their benefits.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Topical interventions for preventing hand-foot syndrome resulting from antineoplastic therapy: A scoping review

Gialaim Purcino dos Reis,

Menêses,

Mazoni

et al. 2023

Rev. esc. enferm. USP

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“…20 Pyridoxine has failed to prevent HFS in several studies. 9,12,13,33 Although some institutions use urea-based cream as a prophylactic measure with capecitabine, its efficacy has been demonstrated only in clinical trials assessing HFSR associated with vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor (TKI). 14,15 Whether diclofenac is effective in VEGF TKI-associated HFSR is not currently known.…”

Section: Discussionmentioning

confidence: 99%

“…11 Several strategies have been evaluated for capecitabineassociated HFS. 12,13 Although urea-based cream is effective in preventing hand-foot skin reaction (HFSR) associated with sorafenib, its role in capecitabine-associated HFS is unclear. 14,15 The placebo-controlled trial did not demonstrate the efficacy of urea-based cream in preventing capecitabine-associated HFS; the other trial lacked a placebo control and reported superiority over an antioxidant cream (mapisal).…”

Section: Introductionmentioning

confidence: 99%

“…16,17 Celecoxib is an effective agent to prevent HFS. 13,18 In an open-labeled randomized controlled trial of 139 patients, grade 2 or 3 HFS incidence was 14.7% with celecoxib compared with 29.6% in the control group. 18 The mechanism postulated was the inhibition of the cyclooxygenase-2 (COX-2) enzyme, which is upregulated because of underlying inflammation in HFS.…”

Section: Introductionmentioning

confidence: 99%

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Topical Diclofenac for Prevention of Capecitabine-Associated Hand-Foot Syndrome: A Double-Blind Randomized Controlled Trial

Santhosh,

Sharma,

Bakhshi

et al. 2024

JCO

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PURPOSE Hand-foot syndrome (HFS) is a dose-limiting side effect of capecitabine. Celecoxib prevents HFS by inhibiting cyclooxygenase-2 (COX-2) that is upregulated because of the underlying associated inflammation. However, systemic side effects of celecoxib have limited routine prescription. Topical diclofenac inhibits COX-2 locally with minimal risk of systemic adverse events. Therefore, we conducted this study to assess the efficacy of topical diclofenac in the prevention of capecitabine-induced HFS. METHODS In this single-site phase III randomized double-blind trial, we enrolled patients with breast or GI cancer who were planned to receive capecitabine-based treatment. Participants were randomly assigned in a 1:1 ratio to receive topical diclofenac or placebo gel for 12 weeks or until the development of HFS, whichever occurred earlier. The primary end point was the incidence of grade 2 or 3 HFS (Common Terminology Criteria for Adverse Events version 5), which was compared between the two groups using simple logistic regression. RESULTS In total, 264 patients were randomly assigned to receive topical diclofenac gel (n = 131) or placebo (n = 133). Grade 2 or 3 HFS was observed in 3.8% of participants in the diclofenac group compared with 15.0% in the placebo group (absolute difference, 11.2%; 95% CI, 4.3 to 18.1; P = .003). Grade 1-3 HFS was lower in the diclofenac group than in the placebo group (6.1% v 18.1%; absolute risk difference, 11.9%; 95% CI, 4.1 to 19.6). Capecitabine dose reductions because of HFS were less frequent in the diclofenac group (3.8%) than in the placebo group (13.5%; absolute risk difference, 9.7%; 95% CI, 3.0 to 16.4). CONCLUSION Topical diclofenac prevented HFS in patients receiving capecitabine. This trial supports the use of topical diclofenac to prevent capecitabine-associated HFS.

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The role of dermocosmetics in the management of cancer-related skin toxicities: international expert consensus

Dreno,

Khosrotehrani,

De Barros Silva

et al. 2023

Support Care Cancer

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Skin toxicities are very common in patients undergoing cancer treatment and have been found to occur with all types of cancer therapeutic interventions (cytotoxic chemotherapy, targeted therapies, immunotherapy, and radiotherapy). Further, skin toxicities can lead to interruption or even discontinuation of anticancer treatment in some patients, translating to suboptimal outcomes. Dermocosmetics (or cosmeceuticals)—defined as skincare solutions incorporating dermatologically active ingredients (beyond vehicle effects) that directly improve symptoms of various skin conditions—are increasingly being used in cancer care to prevent and manage skin toxicities. The active ingredients in these products have a measurable biological action in skin; they typically improve skin integrity (barrier function/hydration and other factors) while relieving skin symptoms. The Association Francophone des Soins Oncologiques de Support (AFSOS) and Multinational Association of Supportive Care in Cancer (MASCC) partnered to select a multidisciplinary group of healthcare professionals involved in the management of patients with cancer and skin toxicities. The group reviewed existing literature and created a summary of recommendations for managing these toxicities through online meetings and communication. In this publication, the group (1) reviews new skin toxicities seen with oncology drugs and (2) evaluates the role of dermocosmetics in improving patient outcomes and minimizing cancer treatment interruptions. We provide general recommendations for initiation and selection of skin care in all oncology patients as well as recommendations for what factors should be considered when using dermocosmetics in specific types of skin toxicities.

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Prophylactic strategies for hand-foot syndrome/skin reaction associated with systemic cancer treatment: a meta-analysis of randomized controlled trials

Cited by 10 publications

References 27 publications

Topical interventions for preventing hand-foot syndrome resulting from antineoplastic therapy: A scoping review

Topical interventions for preventing hand-foot syndrome resulting from antineoplastic therapy: A scoping review

Topical Diclofenac for Prevention of Capecitabine-Associated Hand-Foot Syndrome: A Double-Blind Randomized Controlled Trial

The role of dermocosmetics in the management of cancer-related skin toxicities: international expert consensus

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