Abstract
20750 Background: Cetuximab is a chimeric IgG1 monoclonal antibody against the epidermal growth factor receptor, approved in the treatment of patients (pts) with metastatic colorectal cancer and head and neck squamous cell carcinoma. More than 80% of pts develop cutaneous reactions, mainly as acne-like rash or less frequently as pruritus, dry skin, desquamation, hypertrichosis or nail disorders. It is important to continue the therapy despite toxicity because delaying treatment and lowering doses typically reduce response rates. Methods: From September 2006 to August 2007, 30 pts with metastatic colorectal cancer were treated with cetuximab in combination with chemotherapy. They all suffered from acne-like rash. They were followed for at least 3 months, once per week. Skin care with topical use of creme containing urea and 0.1% K1 vitamin (Reconval K1) was started after the first documented cutaneous toxicity evaluated according to NCI CTCAE, ver.3. Results: Of 30 pts, 6 had grade 3 rush, 18 pts grade 2 and 6 pts grade 1. Reconval K1 was used twice daily. In all pts, cutaneous toxicity was gradually decreasing. The median time to improvement was 8 days and 18 days to observe down-staging in rash by at least 1 grade. In only 3 of 6 pts with grade 3 toxicity, reduction of cetuximab dose was needed, whereas in historical controls, in all pts with grade 3 skin toxicity, reduction of cetuximab dose was recommended and also performed. No dose reduction or delay of treatment was needed in the group of pts with grade 1 and 2 cutaneous toxicity. We didn’t observe any toxicity of topical use of Reconval K1. Conclusions: To our knowledge, this is the first documented effect of topical use of K1 vitamin creme for reducing cetuximab-induced cutaneous toxicity. Reconval K1 is useful in skin care of pts treated with cetuximab. Further studies are needed to evaluate the impact on response rate of cetuximab and quality of life. No significant financial relationships to disclose.
Published Version
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