Management of rash and other toxicities in patients treated with epidermal growth factor receptor-targeted agents

Clin Colorectal Cancer. 2005 Nov:5 Suppl 2:S101-6. doi: 10.3816/ccc.2005.s.014.

Abstract

Inhibition of the epidermal growth factor receptor (EGFR) represents one of the most important avenues for research and development in the field of cancer therapy. The EGFR is a member of the ErbB receptor tyrosine kinase (TK) family, which also includes ErbB-2 (HER2/neu), ErbB-3 (HER3), and ErbB-4 (HER4). Current EGFR therapies available for use include monoclonal antibodies, such as cetuximab, and small-molecule EGFR TK inhibition by agents such as erlotinib. Side effects of these agents include dermatologic manifestations without the bone marrow suppressive properties of chemotherapy. Understanding of rash and how it relates to EGFR inhibitor toxicity and, perhaps more importantly, EGFR inhibitor response must be more clearly defined with clinical trials. The optimum management of rash in patients receiving anti-EGFR therapy remains somewhat controversial; this is secondary to imprecise classification of rash as well as the lack of clinical trials to determine the most appropriate treatment algorithm for these patients. We propose a treatment strategy to help aggressively treat dermatologic side effects allowing patients to continue receiving therapy without dose interruption or drug discontinuation.

Publication types

  • Review

MeSH terms

  • Administration, Topical
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use
  • Drug Eruptions / classification*
  • Drug Eruptions / drug therapy*
  • ErbB Receptors / antagonists & inhibitors*
  • Erlotinib Hydrochloride
  • Humans
  • Protein Kinase Inhibitors / adverse effects*
  • Protein Kinase Inhibitors / therapeutic use
  • Protein-Tyrosine Kinases / antagonists & inhibitors
  • Quinazolines / adverse effects
  • Quinazolines / therapeutic use
  • Steroids / administration & dosage
  • Steroids / therapeutic use

Substances

  • Antibodies, Monoclonal
  • Protein Kinase Inhibitors
  • Quinazolines
  • Steroids
  • Erlotinib Hydrochloride
  • ErbB Receptors
  • Protein-Tyrosine Kinases