Management of cutaneous side effects of cetuximab therapy with vitamin K1 crème

Abstract

Management of cutaneous side effects of cetuximab therapy with vitamin K1 crèmeBackground. Cetuximab is a chimeric human-murine monoclonal antibody against the epidermal growth factor receptor (EGFR). It has shown activities against multiple malignancies in clinical trials. EGFR-inhibitors often cause skin toxicity, most frequently acneiform eruption. Xerosis, eczema, fissures, teleangiectasias, nail changes and paronychia can be seen in some cases, rarely hyperpigmentation. The management of the skin toxicity helps patients to overcome cetuximab-associated skin toxicity and is of great importance for patients' compliance. It is generally manageable with standard topical or systemic antibiotics and anti-inflammatory agents. The education of patients prior to beginning the therapy and proactive intervention at the first signs of skin toxicity are keys to the successful management. The aim of our study was to investigate cutaneous side-effects of the treatment with cetuximab and to determine the efficacy of vitamin K1 crème.Methods. From September 2006 to August 2007 30 patients with metastatic colorectal cancer were treated with cetuximab in combination with chemotherapy and suffered from acne-like rash. They were followed at least 3 months, once per week. Skin care was taken with crème with urea and 0.1% K1 vitamin (Reconval K1®) topically starting after first documented cutaneous toxicity,