Abstract
PurposeEvidence-based guidelines on how to prevent or treat cetuximab-related skin reactions are lacking and multiple care and management strategies are used. The main purpose of the present study is to gain information about the different skincare products being used against skin reactions in metastatic colorectal cancer (mCRC) and recurrent/metastatic (R/M) or locally advanced (LA) squamous cell cancer of the head and neck (SCCHN) patients treated with cetuximab.MethodsAn open-label, prospective observational study conducted in the Netherlands. The occurrence of skin reactions and the care and management options taken were documented for 16 weeks, starting from the first administration of cetuximab.ResultsA total of 103 patients were included in 7 hospitals. 38 patients (37%) developed a grade ≥ 2 skin reaction. Eighty-six patients could be analysed for the primary endpoint (73.3% males, mean age 62.4 years, n = 44 LA SCCHN, n = 16 R/M SCCHN, n = 26 mCRC). The most frequently used skin products at some point during the observation period were moisturizing products (70%), systemic antibiotics (64%), topical antibiotics (58%), lipid-regenerating (28%) and other topical products (28%). The overall use of products gradually increased from baseline to week 6–10, reducing by week 16. Hospital protocols were the primary reason (> 50%) for choice of the skincare products and medications.ConclusionA variety of skin care products and antibiotics were commonly used. Only few patients developed severe cutaneous reactions. For patients, the occurrence of skin reactions did not influence their willingness to continue cetuximab therapy.
Highlights
Cetuximab is a chimeric monoclonal antibody that binds and inactivates the epidermal growth factor receptor (EGFR)
One of the 103 patients was excluded from the Safety Analysis Set (SAS) because the patient withdrew from the study prior to start of treatment (Fig. 1)
Reasons for 17 patients being excluded from the full analysis set (FAS) were missing data: no clear diagnosis of metastatic colorectal cancer (mCRC) or recurrent/ metastatic (R/M) SCCHN recorded (n = 4); no documented cetuximab treatment (n = 14) and insufficient data regarding the primary endpoint at baseline (n = 1)
Summary
Cetuximab is a chimeric monoclonal antibody that binds and inactivates the epidermal growth factor receptor (EGFR). As a consequence of this blockade, extracellular activators like the epidermal growth factor (EGF) cannot bind to the receptor anymore and tumour-promoting downstream signalling cascades cannot be activated. This mechanism of blocking EGFR is an important strategy in the treatment of metastatic colorectal cancer (mCRC) and Support Care Cancer (2021) 29:3497–3506 squamous cell cancer of the head and neck (SCCHN) [1,2,3,4]. Inhibition of EGFR causes abnormal growth and migration behaviour of keratinocytes. In light of the physiologic relevance of the EGFR signalling cascade, one side effect of this type of drug can be explained: various cutaneous toxicities
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