Chemotherapy In Cancer Patients Research Articles

Risk of chemotherapy-induced febrile neutropenia with early discontinuation of pegfilgrastim prophylaxis: a retrospective evaluation using Medicare claims

Background: Two recent evaluations reported that many cancer chemotherapy patients discontinue pegfilgrastim prophylaxis (PP) following the first cycle, and that these patients have a higher subsequent risk of febrile neutropenia (FN). Such evidence is based principally on the experience of younger adults with private healthcare coverage, and the generalizability of results to elderly Medicare patients is unknown.Methods: A matched-cohort design and data from the Medicare Claims Research Identifiable Files were employed. The source population comprised cancer patients aged ≥65 years who received chemotherapy with intermediate/high-risk for FN and first-cycle PP. From the source population, beginning with the second cycle, all patients who received PP in all previous cycles were identified. From this sub-set, patients who did not receive PP in the cycle of interest (“comparison patients”) were matched to those who received PP in that cycle (“PP patients”); the same process was repeated for subsequent cycles. Odds ratios (OR) for FN (broad and narrow definitions) were estimated using generalized estimating equations.Results: Among 77,616 elderly patients in the source population, 5.3% did not receive second-cycle PP and were matched to those who did. In cycle 2, FN odds were significantly higher among comparison patients vs PP patients when employing the broad definition (OR = 1.9, p < .001) and the narrow definition (OR = 2.1, p < .001). Results for subsequent cycles (broad definition: OR = 2.0, p < .001; narrow definition: OR = 2.1, p < .001) and for the last cycle (broad definition: OR = 1.4, p = .060; narrow definition: OR = 1.7, p = .055) were largely comparable.Conclusions: In this large-scale evaluation of elderly Medicare patients who received myelosuppressive chemotherapy and first-cycle PP in recent US clinical practice, FN risk was substantially lower among patients who continued to receive PP in subsequent cycles vs those who discontinued PP.

CN15 - Opinions and experiences of patients receiving oral chemotherapy: A qualitative study

Background: The importance of oral chemotherapy in cancer patients is increasing day by day. Oral chemotherapy drugs provide many advantages in terms of social and economic. The desired impact in oral chemotherapy treatment can be achieved with patient adherence. The aim of this study was to investigate the opininons and experiences of who are receiving oral chemotherapy. Methods: This research was designed as a qualitative study. The study is conducted on eighteen patients who were admitted to the oncology clinic of a university hospital in January 2018. The patients who agreed to participate in the study were included in the study. There is no limitation in the type of cancer disease in the practice of the study. In this study a semi structured interview form was used, this form created as a result of review of the literature. Data were collected through face-to-face individual interviews. All interviews were recorded with voice recorder with permission from the patients. The data obtained from the interviews were transcripted after each interview and evaluated with the thematic content analysis method. Results: As a result of the content analysis identified five main themes. These themes were prescribing oral chemotherapy, administering oral chemotherapy, side effects and control of oral chemotherapy, approach of health professionals, support of family and relatives. In the interviews, the majority of patients were using capecitabine as oral chemotherapy. Patients stated that health professionals for drug use may differ in their recommendations. patients stated that they had problems such as constipation, nausea / vomiting, change of taste, fatigue and mouth instability, and that information on side effect control was made by the physician at the beginning of the treatment. Conclusions: Interdisciplinary approaches are needed to increase compliance of patients with treatment, to monitor treatment side effects and to ensure safe use of medications. It is necessary for nurses to take an active role in patient education and counseling in order to determine the weaknesses and opportunities for recovery of patients during oral chemotherapy. Legal entity responsible for the study: Sevinç Kutlutürkan. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Consensus on clinical diagnosis, treatment and prevention management of chemotherapy induced thrombocytopenia in China(2018)

Chemotherapy induced thrombocytopenia (CIT) is a common side-effect of chemotherapy in cancer patients, which lead to dose and cycle reduction or chemotherapy delay, or even the need of platelet transfusion. Therefore, CIT significantly increases the cost of treatment, reduces the efficacy of chemotherapy and the quality of life, and shortens the survival time of patients. The main treatments of CIT include transfusion of platelets, recombinant human thrombopoietin (rhTPO), and recombinant human interleukin-11 (rhIL-11). RhIL-11 is the first approved thrombocytopoietic cytokine. Interleukin-11 has been shown to be effective in the treatment of thrombocytopenia. RhTPO is a recombinant full-length glycosylated thrombopoietin, which is a ligand for c-Mpl protein. Several observations indicated that administration of rhTPO before and after chemotherapy might be beneficial to patients, which enhances platelet recovery and reduces thrombocytopenia after moderately myelosuppressive regimens. In recent years, the application of rhTPO in CIT treatment has dramatically changed the management and treatment plan of CIT. The China Society of Clinical Oncology (CSCO) published a consensus on CIT in 2014. Based on this, the expert committee updated "Consensus on clinical diagnosis, treatment and prevention management of chemotherapy induced thrombocytopenia in China (2018)" according to the recent literature and clinical research. The new evidence-based practice consensus for CIT aims to provide more reasonable diagnosis, treatment of prevention regimens for CIT patients to maintain the normal platelet counts.

Informed consent for end-of-life chemotherapy in cancer patients: To what extent should we inform patients of our personal opinion?

Informed consent for end-of-life chemotherapy in cancer patients: To what extent should we inform patients of our personal opinion?

PATTERN OF ADVERSE DRUG REACTIONS AND ITS MANAGEMENT IN FEMALE CANCER PATIENTS IN A PRIVATE HOSPITAL IN TELANGANA, INDIA

ABSTRACT&#x0D; Chemotherapy and radiation are one of the important components of treatment for many cancers. Anti-neoplastic agents are used with caution due to their high toxicity and narrow therapeutic window. Studies describing pattern of adverse drug reactions in cancer chemotherapy and radiation therapy patients are less in India. This study aims to evaluate the pattern of ADR’s due to cancer chemotherapy and radiation therapy in hospitalized patients and to assess the causality and severity of these reactions in Telangana state, India. This was a prospective observational study conducted in a private hospital in Telangana region from January to august. Two thousand three hundred and forty two ADR’s were recorded from 254 patients. Most common ADR’s were vomiting (10.7 %), nausea (10.7 %) and fatigue (10.7 %). Majority of the ADR’s (53.5 %) were affecting the Gastro-intestinal system. Naranjo scale for causality assessment showed 54.3 % of the reaction to be “definite”, 36.8 % to be “probable”. Modified Hartwig and Siegel scale for severity showed most reaction (84.1 %) to be of “moderate level”, while 13.3 % of reactions were of “mild level”. There is an immediate need to create awareness among health care professionals regarding the importance of the pharmacovigilance system. Use of preventive measures is to be enhanced in order to reduce the incidence and severity of ADR’s. This study showed most ADR’s are preventable with effective ADR monitoring.&#x0D; Keywords: Adverse drug reaction (ADR), ADR monitoring, Pharmacovigilance, chemotherapy, radiation therapy.

Shared decision making can aid the informed consent process for end-of-life chemotherapy in cancer patients.

Shared decision making can aid the informed consent process for end-of-life chemotherapy in cancer patients.

A Multiplexed Screening Assay to Evaluate Chemotherapy-Induced Myelosuppression Using Healthy Peripheral Blood and Bone Marrow

Myelosuppression is a major side effect of chemotherapy in cancer patients and can result in infections, bleeding complications, and increased risk of morbidity and mortality, as well as limit the drug dose and frequency of administration. Chemotherapy-induced myelosuppression is caused by the disruption of normal hematopoiesis. Thus, prior understanding of the adverse effects of chemotherapies on hematopoietic cells is essential to minimize the side effects of cancer treatment. Traditional methods such as colony-forming assays for studying chemotherapy-induced myelosuppression are time-consuming and labor intensive. High-throughput flow cytometry technologies and methods to detect rare hematopoietic cell populations are critical in advancing our understanding of how different blood cell types in complex biological samples respond to chemotherapeutic drugs. In the present study, hematopoietic progenitor cells were induced to differentiate into megakaryocytes and myeloid lineage cells. The expanded cells were then used in a multiplexed assay to monitor the dose-response effects of multiple chemotherapies on different stages of megakaryocyte differentiation and myeloid cell populations in a 96-well plate format. The assay offers an alternative method to evaluate the myelosuppressive potential of novel chemotherapeutic drugs compared to traditional lower throughput and labor-intensive assays.

Doxorubicin‐induced cardiomyocyte toxicity – protective effects of endothelial cells in a tri‐culture model system

AbstractDoxorubicin‐induced cardiomyopathy is a clinically prevalent pathology, occurring as a sequelae following chemotherapy for cancer patients. In particular, the “first dose” effect has been particularly challenging, given the heterogeneous and multifactorial nature of this pathophysiology. Here, we describe the development of a physiologically relevant in vitro model for cardiotoxicity testing, using human cells. Primary cardiomyocytes, endothelial, and smooth muscle cells were tri‐cultured in 2D, or within nano‐fibrous scaffolds in a 3D environment, under dynamic nutrient flow, using the Quasi Vivo® system. State‐of‐the‐art sensor chips were used to detect troponin I levels, 2 h after acute exposure to doxorubicin. We demonstrate a significant improvement in cardiomyocyte viability when grown in a 3D tri‐culture environment over a 5‐day period and a 10‐fold reduction in doxorubicin‐induced toxicity. Our tri‐culture model can be used as a valuable tool for physiologically relevant assessment of drug‐induced cardiotoxicity in vitro.

Antibiotic prophylaxis in veterinary cancer chemotherapy: A review and recommendations.

Bacterial infection following cancer chemotherapy-induced neutropenia is a serious cause of morbidity and mortality in human and veterinary patients. Antimicrobial prophylaxis is controversial in the human oncology field, as any decreased incidence in bacterial infections is countered by patient adverse effects and increased antimicrobial resistance. Comprehensive guidelines exist to aid human oncologists in prescribing antimicrobial prophylaxis but similar recommendations are not available in veterinary literature. As the veterinarian's role in antimicrobial stewardship is increasingly emphasized, it is vital that veterinary oncologists implement appropriate antimicrobial use. By considering the available human and veterinary literature we present an overview of current clinical practices and are able to suggest recommendations for prophylactic antimicrobial use in veterinary cancer chemotherapy patients.

Tailored Strategies to Enhance Survey Response among Proxies of Deceased Patients.

To enhance proxy survey responses for deceased cancer patients. Two waves of surveys about care experiences of cancer chemotherapy patients (used for a value-based purchasing initiative), collected November 2016 through March 2017. Surveys were mailed to deceased patients (for proxy response) in the untailored first survey wave, and using a tailored strategy in the second wave. We compared proxy responses for deceased patients with and without the tailored approach. A tailored survey approach improved the proxy response rate from 17.6 percent to 39.0 percent. Simple tailoring strategies can significantly enhance proxy response rates when surveying patients in a high mortality population. However, we were unable to address the impact of higher proxy response rates on response bias since we surveyed different patients in each wave.

A phase iia trial of acupuncture to reduce chemotherapy-induced peripheral neuropathy severity during neoadjuvant or adjuvant weekly paclitaxel chemotherapy in breast cancer patients.

e22201Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and potentially dose-limiting side effect of neurotoxic chemotherapy for cancer patients. We evaluated the preliminar...

Abrogation of Hepatic Damage Induced by Anticancer Drug Methotrexate by Zobo (Hibiscus sabdariffa extract) Supplementation via Targeting Oxidative Hepatotoxicity in Rats

ABSTRACTClinical use of methotrexate (MTX) in cancer chemotherapy is limited due to its side effects, notably associated with increased oxidative stress and hepatotoxicity. Zobo is an aqueous extract of Hibiscus sabdariffa known to contain natural antioxidants. The present study investigated the hepatoprotective effect of zobo drink (ZD) on MTX-induced oxidative stress and hepatotoxicity in rats. Rats randomized to control group received distilled water orally; MTX group received intraperitoneal (ip) injection of MTX (20 mg/kg) on day 11; ZD + MTX group was administered ZD (10 ml/kg) for 14 days and was injected with MTX on day 11. Three days after MTX injection, enzyme markers of liver injury, protein profile, and bilirubin were assessed in serum. Hepatic activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) and level of lipid peroxidation were estimated. Histopathological changes were carried out on the liver tissue. MTX induced prominent oxidative hepatotoxicity demonstrated by significant (p < .01) increases in serum liver enzymes and bilirubin, while protein profile was markedly reduced (p < .05). Hepatic activities of SOD, CAT, and GPx considerably decreased, whereas lipid peroxidation increased significantly in the MTX group compared to control. By contrast, ZD administration attenuated and restored the markers of liver injury, hepatic antioxidant enzymes, and lipid peroxidation near to control, while histopathological alterations were ameliorated compared to the MTX group. ZD affords superior protection against MTX-induced oxidative hepatotoxicity via improvement in antioxidant defense systems in rats. ZD could be a potent natural product against hepatotoxicity associated with MTX chemotherapy in cancer patients.

Ayurvedic approach for the treatment of side effects caused by radiotherapy and chemotherapy in cancer patients

Ayurveda has its own role in the prevention and management of cancer’s complications. Chemo- and radiotherapy are highly toxic and both damage adjacent healthy cells. Their side effects may be acute like nausea, vomiting, diarrhea and fatigue or chronic like pharyngitis, esophagitis, laryngitis and persistent dysphasia. According to Ayurveda, many medicines show the anticancer properties such as Brihamarasayan, Brahmi, Guduchi, Yasthimadhu, Ashwgandha, and Amalaki which can be helpful in treating cancer as well as the side effects caused by chemo- and radiotherapy in cancer patients. In the present work, the literature regarding classical Ayurvedic texts, research papers in peer reviewed journals and related data of different websites was critically reviewed. The review concludes that Ayurvedic Medicines have effective result in cancer and reducing the complications.

AN ANALYSIS ON THE COMPATIBILITY OF REAL COST AND INA-CBGS COST DETERMINATION IN RECTUM CANCER CHEMOTHERAPY PATIENT TO THE IMPLEMENTATION OF NATIONAL HEALTH INSURANCE IN SANGLAH CENTRAL GENERAL HOSPITAL OF DENPASAR IN 2014

The problem frequently found in JKN (National Health Insurance) implementation the payment of which is based on INA-CBGs tariff is the difference of real cost and the INA-CBGs tariff. The objective of research was to find out the difference of real cost without chemotherapy and INA-CBGs tariff, the highest cost component in real cost without chemotherapy, and to find out the amount of real cost without chemotherapy related to the chemotherapy cycle regularity in rectum cancer inpatient in Sanglah Central General Hospital of Denpasar (RSUP Sanglah Denpasar). This study was an observational research with cross sectional design according to the hospitals’ perspective. The data was collected retrospectively including the document of claim and treatment cost for rectum cancer chemotherapy patient in January-August 2014. The data was analyzed using one sample t-test to compare the real cost and the INA-CBGs tariff. The result of research showed the positive average difference of cost real from INA-CBGs tariff in which in C-4-13-I the First Class of Treatment was IDR. 3.716.554; Second Class of Treatment was IDR 2.930.222; Third Class of treatment was IDR 3.009.750. In C-4-13-II, the First Class of Treatment was IDR. 7.680.392; Third Class of treatment was IDR 6.351.268, and in C-4-13-III, the First Class of Treatment was IDR. 10.179.575; Third Class of treatment was IDR 10.031.690. Accommodation cost the highest component of real cost. The irregular cycle pattern had the higher mean real cost than the regular of chemotherapy cycles

AN ANALYSIS ON THE COMPATIBILITY OF REAL COST AND INA-CBGS COST DETERMINATION IN RECTUM CANCER CHEMOTHERAPY PATIENT TO THE IMPLEMENTATION OF NATIONAL HEALTH INSURANCE IN SANGLAH CENTRAL GENERAL HOSPITAL OF DENPASAR IN 2014

The problem frequently found in JKN (National Health Insurance) implementation the payment of which is based on INA-CBGs tariff is the difference of real cost and the INA-CBGs tariff. The objective of research was to find out the difference of real cost without chemotherapy and INA-CBGs tariff, the highest cost component in real cost without chemotherapy, and to find out the amount of real cost without chemotherapy related to the chemotherapy cycle regularity in rectum cancer inpatient in Sanglah Central General Hospital of Denpasar (RSUP Sanglah Denpasar). This study was an observational research with cross sectional design according to the hospitals’ perspective. The data was collected retrospectively including the document of claim and treatment cost for rectum cancer chemotherapy patient in January-August 2014. The data was analyzed using one sample t-test to compare the real cost and the INA-CBGs tariff. The result of research showed the positive average difference of cost real from INA-CBGs tariff in which in C-4-13-I the First Class of Treatment was IDR. 3.716.554; Second Class of Treatment was IDR 2.930.222; Third Class of treatment was IDR 3.009.750. In C-4-13-II, the First Class of Treatment was IDR. 7.680.392; Third Class of treatment was IDR 6.351.268, and in C-4-13-III, the First Class of Treatment was IDR. 10.179.575; Third Class of treatment was IDR 10.031.690. Accommodation cost the highest component of real cost. The irregular cycle pattern had the higher mean real cost than the regular of chemotherapy cycles

Dacomitinib potentiates the efficacy of conventional chemotherapeutic agents via inhibiting the drug efflux function of ABCG2 in vitro and in vivo

BackgroundATP-binding cassette subfamily G member 2 (ABCG2), a member of the ABC transporter superfamily proteins, mediates multidrug resistance (MDR) by transporting substrate anticancer drugs out of cancer cells and decreasing their intracellular accumulation. MDR is a major hurdle to successful chemotherapy. A logical approach to overcome MDR is to inhibit the transporter. However, no safe and effective MDR inhibitor has been approved in the clinic.MethodsThe MTT assay was used to evaluate cell cytotoxicity and MDR reversal effect. Drug efflux and intracellular drug accumulation were measured by flow cytometry. The H460/MX20 cell xenograft model was established to evaluate the enhancement of anticancer efficacy of topotecan by dacomitinib in vivo. To ascertain the interaction of dacomitinib with the substrate binding sites of ABCG2, the competition of dacomitinib for photolabeling of ABCG2 with [125I]- iodoarylazidoprazosin (IAAP) was performed. Vanadate-sensitive ATPase activity of ABCG2 was measured in the presence of a range of different concentrations of dacomitinib to evaluate the effect of dacomitinib on ATP hydrolysis as the energy source of the transporter. A flow cytometry-based assay and western blotting were employed to study whether dacomitininb could inhibit the expression level of ABCG2. The mRNA expression levels of ABCG2 were analyzed by real-time quantitative RT-PCR. The protein expression level of AKT, ERK and their phosphorylations were detected by Western blotting.ResultsHere, we found that dacomitinib, an irreversible pan-ErbB tyrosine kinase inhibitor (TKI) in phase III clinical trial, could enhance the efficacy of conventional chemotherapeutic agents specifically in ABCG2-overexpressing MDR cancer cells but not in the parental sensitive cells. Dacomitinib was found to significantly increase the accumulation of ABCG2 probe substrates [doxorubicin (DOX),Rhodamine 123 (Rho 123) and Hoechst 33342] by inhibiting the transporter efflux function. Moreover, dacomitinib stimulated ABCG2 ATPase activity and competed with [125I]-IAAP photolabeling of ABCG2 in a concentration-dependent manner. However, dacomitinib did not alter ABCG2 expression at protein and mRNA levels or inhibit ErbB downstream signaling of AKT and ERK. Importantly, dacomitinib significantly enhanced the efficacy of topotecan in ABCG2-overexpressing H460/MX20 cell xenografts in nude mice without incurring additional toxicity.ConclusionsThese results suggest that dacomitinib reverses ABCG2-mediated MDR by inhibiting ABCG2 efflux function and increasing intracellular accumulation of anticancer agents. Our findings advocate further clinical investigation of combinations of dacomitinib and conventional chemotherapy in cancer patients with ABCG2-overexpressing MDR tumors.

Hepatobiliary phase liver MR imaging findings after Oxaliplatin-based chemotherapy in cancer patients.

To describe Gd-EOB-DTPA-enhanced liver MR imaging findings in colon and rectal cancer patients who received Oxaliplatin. Spectrum of hepatobiliary phase imaging findings include diffuse heterogeneous dysfunction, macronodular and micronodular FNH-like lesions, and coexistence of periportal increased liver function with FNH-like lesions. Differentiation of these benign lesions from metastasis is crucial to avoid biopsy in patients with colorectal cancers and may allow better understanding of sinusoidal obstruction syndrome pathophysiology and regenerative response of liver.

Chemotherapy in cancer patients undergoing haemodialysis: a nationwide study in Japan

BackgroundCancer is a major cause of death in patients undergoing haemodialysis. However, information about the actual clinical practice of chemotherapy for patients with cancer undergoing haemodialysis is lacking. We conducted a nationwide survey using questionnaires on the clinical practice of chemotherapy for such patients.Patients and methodsThe nationwide survey included patients undergoing haemodialysis who were subsequently diagnosed with cancer in 20 hospitals in Japan from January 2010 to December 2012. We reviewed their clinical data, including cancer at the following primary sites: kidney, colorectum, stomach, lung, liver, bladder, pancreas and breast. The questionnaires consisted of the following subjects: (1) patient characteristics; (2) regimen, dosage and timing of chemotherapy; and (3) clinical outcome.ResultsOverall, 675 patients were registered and assessed for main primary cancer site involvement. Of 507 patients with primary site involvement, 74 patients (15%) received chemotherapy (44 as palliative chemotherapy and 30 as perioperative chemotherapy). The most commonly used cytotoxic drugs were fluoropyrimidine (15 patients), platinum (8 patients) and taxane (8 patients), and the dosage and timing of these drugs differed between institutions; however, the dosage of molecular targeted drugs (24 patients) and hormone therapy drugs (15 patients) was consistent. The median survival time of patients receiving palliative chemotherapy was 13.0 months (0.1–60.3 months). Three patients (6.8%) died from treatment-related causes and nine patients (20%) died of causes other than cancer. Of the 30 patients who received perioperative chemotherapy, 6 (20%) died of causes other than cancer within 3 years after the initiation of chemotherapy.ConclusionAmong the haemodialysis patients with cancer who received chemotherapy, the rates of mortality from causes other than cancer might be high for both palliative and perioperative chemotherapy. Indications for the use of chemotherapy in patients undergoing haemodialysis should be considered carefully.

L-Carnitine supplementation reduces the general fatigue of cancer patients during chemotherapy.

L-Carnitine (LC) plays an important role in the metabolism of fatty acids, and LC deficiency is associated with a feeling of weakness or general fatigue. Cancer patients receiving chemotherapy often develop LC deficiency, which is considered to be a factor contributing to general fatigue. The aim of the present study was to evaluate the efficacy of LC supplementation as a treatment for general fatigue in cancer patients during chemotherapy. A total of 11 cancer patients who were suffering from general fatigue during chemotherapy in our hospital between September 2014 and December 2015 were examined (6 cases involved adjuvant chemotherapy and 5 cases involved chemotherapy for unresectable or recurrent disease). The patients were administered 1,500 mg/day of levocarnitine per os, and the change in mean daily fatigue from the baseline to 8 weeks was assessed using the Brief Fatigue Inventory. The change in the plasma levels of albumin and the lymphocyte counts from the baseline to 8 weeks were also assessed. LC supplementation reduced general fatigue in all cases. Moreover, LC supplementation maintained the plasma levels of albumin and lymphocyte counts during chemotherapy, and enabled patients to continue chemotherapy sequentially without dose reduction. Therefore, LC supplementation improved general fatigue in all the examined cancer patients during chemotherapy. This treatment may make improve the tolerability of chemotherapy in cancer patients by reducing general fatigue and improving the nutritional status.

Cutaneous Adverse Reactions of Chemotherapy in Cancer Patients: A Clinicoepidemiological Study.

Background:The diagnosis of cutaneous adversities in the cancer patient is especially difficult, given the complexity of their illness and combination protocols used for the treatment. The present study was undertaken to know the spectrum of cutaneous adversities in patients undergoing chemotherapy and the drug(s) most commonly associated with it.Materials and Methods:A total of 1000 patients with malignancies under chemotherapy in the oncology ward and outpatient department were screened in this observational study from January 2013 to February 2015. Relevant investigations for diagnosis of malignancies under chemotherapy and dermatological disorders were carried out.Results:Three hundred and eighty-four patients presented with cutaneous adversities of chemotherapy. The most common was anagen effluvium (78.6%), followed by xerosis (4.4%), thrombophlebitis (3.1%), generalised pruritus (2.9%), melanonychia (2.9%), hand-foot syndrome (2.6%), extravasation reactions (1.8%), flagellate dermatosis (1.3%), prurigo nodularis (0.8%), exfoliation (0.5%), ichthyosis (0.5%), papulopustular rash (0.3%), bullous photodermatitis (0.3%), and Sweet's syndrome (0.3%). Chemotherapeutic drugs were mostly given in combinations. Most common drugs to cause anagen effluvium were alkylating agents in combinations, hand-foot syndrome by taxanes (docetaxel), flagellate dermatoses by antitumour antibiotics (bleomycin), and exfoliation by antimetabolites (methotrexate). The limitation of this study was to imply a specific drug as the causation of the cutaneous adversities since the chemotherapy mostly consisted of combination protocols. Therefore, we have tried to associate the drug combination itself.Conclusion:Chemotherapeutic drugs produce a range of cutaneous adversities, certain specific adversities pertaining to drugs, and their combinations have been implicated which should be looked for and managed accordingly. Knowledge of the adverse effects of anticancer drugs will help reduce the psychological trauma and improve the quality of life.