The management of EGFR inhibitor adverse events: a case series and treatment paradigm

Abstract

The most common cutaneous adverse event in our cohort was papulopustular rash, followed by eczema and xerosis. Patients were managed with symptom target therapy, and suspension of the EGFR inhibitor was rarely required. As the use of EGFR inhibitors increases, it is important to promptly identify and treat adverse events. Further studies are necessary to develop targeted therapeutic and preventative measures.

Atypical skin reaction in a patient treated with gefitinib for advanced lung cancer: A case report and review of the literature

“…Papulopustular acne-like eruption is the most common cutaneous adverse event (5) with an incidence rate of 55% (1). Xerosis, pruritus, desquamation, eczematous eruptions, teleangectasia, hyperpigmentation, trichomegalia, alopecia and nail alterations have also been reported (6)(7)(8).…”

“…EGFR has been found to be overexpressed in certain types of solid tumors, such as colon, pancreas, lung and breast tumors, and leads to the dysregulation of cell growth (1).…”

“…Therapeutic agents with two main anti-EGFR mechanisms are used in clinical practice: Low molecular-weight tyrosine kinase inhibitors that compete with adenosine triphosphate (ATP) for binding with the tyrosine kinase portion of a mutant EGFR receptor, and monoclonal antibodies directed against the ligand-binding extracellular domain (1).…”

Local cortisol activation is involved in EGF-induced immunosuppression

“…20 Other skin reactions, such as xerosis, pruritis, desquamation, and eczematous eruptions, have also been reported in response to EGFR inhibitor treatment. 21 The most common treatment for papulopustular eruptions is topical application of corticosteroids or tetracycline-family antibiotics.…”

The epidermal growth factor receptor in squamous cell carcinoma: An emerging drug target

“…These side effects have been reviewed in depth elsewhere. 17,78 The most commonly reported of these is the acneiform or papulopustular rash. Less common side effects include a desquamating rash, eczema, xerosis, paronychia and alopecia.…”