Cutaneous toxicities of epidermal growth factor receptor inhibitors: A prospective study in 60 Asian patients

Abstract

© 2019, Allergy and Immunology Society of Thailand. All rights reserved. Background: Several prospective studies have been conducted in epidermal growth factor receptor (EGFR) inhibitor -related cutaneous reactions in Caucasian patients, but prospective studies in Asian populations are scarce. Objective: To investigate the cutaneous side effects of EGFR inhibitors in Asian cancer patients and to assess tumor response to dermatologic manifestations. Methods: Sixty patients with lung or colorectal cancer who were receiving EGFR inhibitors were prospectively followed for at least one year by oncologists and dermatologists. Results: Of 60 patients (33 males, 27 females), 46 lung cancer patients received erlotinib (n = 29) and gefitinib (n = 17). Cetuximab was prescribed in 14 colorectal cancer patients. Fifty-eight patients (58/60, 96.7%) developed cutaneous reactions. The most common reactions were xerosis (82.8%), acne (79.3%), and skin desquamation (62.1%). Most reactions were mild and well-tolerated. Of 14 patients who had severe reactions, temporary treatment interruption was necessary in 3 patients and a decreasing dose was required in another 3 patients. There were no statistically significant differences in type, severity, or number of cutaneous reactions between responders (29/58) and non-responders (29/58) to EGFR inhibitors. At median follow-up time of 11.92 ± 1.08 months, no patient died from cutaneous toxicities. Nine patients died from cancer and 11 patients lost to follow-up. Conclusion: In this Asian population, almost all patients (96.7%) developed cutaneous toxicities of EGFR inhibitors. Xerosis, acne, and desquamation were common in Asian cancer patients. Most reactions were mild and well tolerated. Due to limited number of patients, this study did not show significant associations between cutaneous toxicities and tumor response.