Efficacy of Topical Compound Danxiong Granules for Treatment of Dermatologic Toxicities Induced by Targeted Anticancer Therapy: A Randomized, Double-Blind, Placebo-Controlled Trial.

Aiping Tian,Hongzhe Shi,Xinyu Bi,Boyan Yang,Zhen Huang,Wen Zhang,Wei Chen,Shangying Hu,Aiping Zhou,Zhichao Jiang

doi:10.1155/2017/3970601

Abstract

Dermatologic toxicities resulting in dose reduction or discontinuation of treatment pose challenges for targeted anticancer therapies. We conducted this randomized, double-blind, placebo-controlled trial to investigate the efficacy of topical application of Compound Danxiong Granules (CDG) for treatment of dermatologic toxicities associated with targeted anticancer therapies. One hundred and ten patients with dermatologic toxicities induced by targeted anticancer therapies were randomly assigned to CDG or placebo group. Each crude herb (Rhizoma Chuanxiong, Paeonia suffruticosa Andr., Cortex Phellodendri, Geranium sibiricum L., and Flos Carthami) was prepared as an instant herbal powder. Application of the CDG via topical washes lasted 20 minutes, twice daily, for 10 days. The primary outcome was the total effective rate, defined as reduction in at least one grade of skin toxicity. The total effective rate was 77.61% (52/67) in the CDG group and 27.27% (9/33) in the placebo group (P < 0.0001). Compared to the placebo treatment, CDG treatment achieved a higher total effective rate for hand-foot skin reaction (95.45% versus 27.27%), acneiform eruption (69.23% versus 30.78%), and paronychia (68.42% versus 22.22%). Topical application of CDG can effectively attenuate dermatologic toxicities induced by targeted anticancer therapies. The effect of CDG was more pronounced in hand-foot skin reaction.

Highlights

Targeted anticancer therapies have improved survival outcomes in various cancer patients [1]
Patient eligibility was based on the following inclusion criteria: (1) aged 18 years or over; (2) an Eastern Cooperative Oncology Group performance status ≤ 3; (3) malignant tumor diagnosed by evidence of pathological or cytological findings; (4) treatment with targeted anticancer agents and occurrence of dermatologic toxicities including acneiform eruption, paronychia, and hand-foot skin reaction; and (5) not receiving other preparations of traditional herbal medicines during the 4 weeks before enrollment
Our study suggests that topical application of Compound Danxiong Granules (CDG) can effectively attenuate dermatologic toxicities associated with targeted anticancer therapy

Summary

Introduction

Targeted anticancer therapies have improved survival outcomes in various cancer patients [1]. Anticancer agents target signal transduction, tumor angiogenesis, or tumor microenvironment pathways [2]. Introduction of these agents has been associated with a wide spectrum of dermatologic toxicities [3]. Despite the fact that these dermatologic toxicities are not life threatening, dose reduction or discontinuation of cancer treatment and impairments in patient quality of life pose a great challenge for targeted cancer therapies [5]. Management of these dermatologic toxicities further increases the economic burden of cancer care [6]. There is an urgent need to find an alternative therapeutic agent to prevent and manage dermatologic toxicities induced by targeted anticancer therapies

Methods

Results

Discussion

Conclusion