Abstract
Treatment of head and neck cancers requires multidisciplinary collaboration to reduce morbidity and mortality associated with the tumor burden, as well as to preserve function of organs and structures. With the use of various new targeted therapies come new adverse events including dermatologic toxicities, which may consist of xerosis, nail and hair changes, morbilliform or papulopustular rashes, to more severe eruptions such as Stevens–Johnson syndrome. We describe the dermatologic toxicities and corresponding grades of severity and associated pathophysiology resulting from seven therapeutics used to treat head and neck cancers: cetuximab, trastuzumab, pembrolizumab, nivolumab, lentatinib, larotrectinib, and entrectinib. Being familiar with these dermatologic toxicities allows clinicians to provide comprehensive counseling for patients, encourage preventative measures, and to know when it is appropriate to hold therapy or permanently stop treatment.
Highlights
Head and neck (H&N) cancers are those that primarily affect the lip, oral cavity, pharynx, larynx, and paranasal sinuses [1]
In this review we aim to describe the dermatologic toxicities and corresponding treatments associated with the following H&N cancer therapeutics: cetuximab, trastuzumab, pembrolizumab, nivolumab, lentatinib, larotrectinib, and entrectinib
The inhibitor promotes chemokine expression leading to apoptosis of keratinocytes [38]. These numerous changes result in hyperkeratosis, follicular plugging, and inflammation which manifest as a papulopustular rash which is a common and well-established side effect of HER1/ epidermal growth factor (EGFR) inhibitor treatments as it is reported to occur at some point during therapy in 60–90% of treated patients [38]
Summary
Head and neck (H&N) cancers are those that primarily affect the lip, oral cavity, pharynx, larynx, and paranasal sinuses [1]. With the use of various new targeted therapies come new adverse events including dermatologic toxicities which may range from a limited morbiliform rash to diffuse bullous eruptions and more severe manifestations. These dermatologic toxicities can greatly impact a patient’s quality of life so clinicians must be familiar with these toxicities, know how to manage them, and recognize when it is necessary to hold or permanently stop the targeted therapies. We will cover common skin reaction patterns resulting from targeted therapies and immunotherapies and will review each of these seven therapeutics independently
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