Abstract

The aim of the present study was to examine the effect of orally administered sorafenib (Nexavar®), sunitinib (Sutent®) and capecitabine (Xeloda®), which cause palmoplantar erythrodysesthesia (PPE), on the antioxidant status of the skin and the formation of free radicals. A total of 42 patients were enrolled, of which 36 (85%) completed the study. Overall, 19 received capecitabine (2,000-4,000 mg per day), 10 sunitinib (25-50 mg per day) and 7 sorafenib (400-800 mg per day). Cutaneous carotenoids as markers of the antioxidant status of the skin were measured 1 day before the first oral administration (Tbase) and at day 18 of treatment (T1). The mean antioxidant concentrations increased significantly in patients treated with sunitinib from 3.99±1.01 to 4.68±1.32, p=0.047 and sorafenib from 4.83±0.74 to 5.3±0.78, p=0.007. Treatment with capecitabine did not significantly increase the mean antioxidant concentration. Formation of free radicals may not be the underlying patho-mechanism of tyrosine kinase inhibitors (TKI)- and capecitabine-associated PPE.

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