Chemotherapy-induced Hand-foot Syndrome Research Articles

436P Chemotherapy-induced hand-foot syndrome, comparative efficacy and safety of pharmacological prophylaxis: Systematic review and network meta-analysis

436P Chemotherapy-induced hand-foot syndrome, comparative efficacy and safety of pharmacological prophylaxis: Systematic review and network meta-analysis

CN73 Symptom management in patients with chemotherapy-induced hand-foot syndrome: A qualitative study

CN73 Symptom management in patients with chemotherapy-induced hand-foot syndrome: A qualitative study

Symptom management in patients with chemotherapy-induced hand-foot syndrome: a qualitative study

Symptom management in patients with chemotherapy-induced hand-foot syndrome: a qualitative study

1579P Prophylactic strategies for hand-foot syndrome/skin reaction associated with systemic cancer treatment: A meta-analysis of randomized controlled trials

Hand-foot syndrome (HFS) and Hand Foot Skin Reaction (HFSR) are common toxicities of several systemic cancer treatments. Multikinase inhibitor- induced HFSR is distinguished from chemotherapy-induced HFS in terms of pathogenesis, symptomatology, and treatment. Multiple trials have investigated the efficacy of preventive strategies such as COX-inhibitors, pyridoxine and urea cream, however, no consensus has been made. This meta-analysis evaluated data from high quality trials to provide strong evidence in forming recommendations to prevent systemic cancer therapy-induced HFS/HFSR.

Carotenoids in Human SkinIn Vivo: Antioxidant and Photo-Protectant Role against External and Internal Stressors.

The antioxidant system of the human body plays a crucial role in maintaining redox homeostasis and has an important protective function. Carotenoids have pronounced antioxidant properties in the neutralization of free radicals. In human skin, carotenoids have a high concentration in the stratum corneum (SC)—the horny outermost layer of the epidermis, where they accumulate within lipid lamellae. Resonance Raman spectroscopy and diffuse reflectance spectroscopy are optical methods that are used to non-invasively determine the carotenoid concentration in the human SC in vivo. It was shown by electron paramagnetic resonance spectroscopy that carotenoids support the entire antioxidant status of the human SC in vivo by neutralizing free radicals and thus, counteracting the development of oxidative stress. This review is devoted to assembling the kinetics of the carotenoids in the human SC in vivo using non-invasive optical and spectroscopic methods. Factors contributing to the changes of the carotenoid concentration in the human SC and their influence on the antioxidant status of the SC in vivo are summarized. The effect of chemotherapy on the carotenoid concentration of the SC in cancer patients is presented. A potential antioxidant-based pathomechanism of chemotherapy-induced hand-foot syndrome and a method to reduce its frequency and severity are discussed.

Prophylactic strategies for hand-foot syndrome/skin reaction associated with systemic cancer treatment: a meta-analysis of randomized controlled trials.

Hand-foot syndrome (HFS) and hand-foot skin reaction (HFSR) are common toxicities of several systemic cancer treatments. Multikinase inhibitor-induced HFSR is distinguished from chemotherapy-induced HFS in terms of pathogenesis, symptomatology, and treatment. Multiple trials have investigated the efficacy of preventive strategies such as COX-inhibitors, pyridoxine, and urea cream; however, no consensus has been made. This meta-analysis evaluated data from high-quality trials to provide strong evidence in forming recommendations to prevent systemic cancer therapy-induced HFS/HFSR. A systematic search of PubMed, Embase, Cochrane, clinical trials databases, and hand searching were utilized to identify randomized trials (RCTs) investigating prophylactic strategies for HFS/HFSR in cancer patients receiving systemic treatment. Trials published until August 2021 were included. Using the random effects model, pooled odds ratios were calculated for rates of all-grade and severe HFS/HFSR. Subgroup analysis based on type of cancer treatment given was done. Sixteen RCTs were included (N=2814). For all-grade HFS/HFSR, celecoxib (OR 0.52, 95% CI 0.32-0.85, p=0.009) and urea cream (OR 0.48, 95% CI 0.39-0.60, p<0.00001) both showed statistically significant risk reduction. Celecoxib was effective in preventing HFS in patients who received capecitabine (50.5% vs 65%, p=0.05), while urea cream was effective in both capecitabine HFS (22.3% vs 39.5%, p=0.02) and sorafenib-induced HFSR (54.9% vs 71.4%, p<0.00001). Pyridoxine at higher doses showed a trend towards benefit in preventing all grade HFS (69.6% vs 74.1%, p=0.23). Urea cream and celecoxib are both effective in preventing HFS/HFSR in patients receiving systemic cancer treatment. Particularly, celecoxib is more effective in preventing all-grade capecitabine-induced HFS, while urea cream shows more benefit in preventing moderate to severe sorafenib-induced HFSR. Studies investigating optimal dosing for celecoxib and urea cream are recommended. There is inadequate evidence to make recommendations regarding pyridoxine.

Progress in TCM Treatment of Chemotherapy-induced Hand-foot Syndrome in Malignant Tumors

Antineoplastic drugs are easy to cause hand-foot syndrome in patients, seriously affect the quality of life, and even affect the dose or course of chemotherapy, and then affect the therapeutic effect. At present, there is no unified treatment standard in western medicine. Some studies have confirmed that the hand and foot of traditional Chinese medicine has a certain clinical effect on hand and foot syndrome. This paper mainly summarizes the clinical research results of traditional Chinese medicine on malignant tumor chemotherapy hand and foot syndrome by consulting the relevant literature, in order to provide reference for clinical drug use.

Spermine-Related DNA Hypermethylation and Elevated Expression of Genes for Collagen Formation are Susceptible Factors for Chemotherapy-Induced Hand-Foot Syndrome in Chinese Colorectal Cancer Patients.

Hand-foot syndrome (HFS) is a common capecitabine-based chemotherapy-related adverse event (CRAE) in patients with colorectal cancer (CRC). It is of great significance to comprehensively identify susceptible factors for HFS, and further to elucidate the biomolecular mechanism of HFS susceptibility. We performed an untargeted multi-omics analysis integrating DNA methylation, transcriptome, and metabolome data of 63 Chinese CRC patients who had complete CRAE records during capecitabine-based chemotherapy. We found that the metabolome changes for each of matched plasma, urine, and normal colorectal tissue (CRT) in relation to HFS were characterized by chronic tissue damage, which was indicated by reduced nucleotide salvage, elevated spermine level, and increased production of endogenous cytotoxic metabolites. HFS-related transcriptome changes of CRT showed an overall suppressed inflammation profile but increased M2 macrophage polarization. HFS-related DNA methylation of CRT presented gene-specific hypermethylation on genes mainly for collagen formation. The hypermethylation was accumulated in the opensea and shore regions, which elicited a positive effect on gene expression. Additionally, we developed and validated models combining relevant biomarkers showing reasonably good discrimination performance with the area under the receiver operating characteristic curve values from 0.833 to 0.955. Our results demonstrated that the multi-omics variations associated with a profibrotic phenotype were closely related to HFS susceptibility. HFS-related biomolecular variations in CRT contributed more to the relevant biomolecular mechanism of HFS than in plasma and urine. Spermine-related DNA hypermethylation and elevated expression of genes for collagen formation were closely associated with HFS susceptibility. These findings provided new insights into the susceptible factors for chemotherapy-induced HFS, which can promote the implementation of individualized treatment against HFS.

The Effect of Traditional Korean Medicine for Chemotherapy-Induced Hand-Foot Syndrome in Cancer Patients: Review

Objectives: Hand-foot syndrome (HFS) is a common adverse effect of chemotherapy in cancer patients. This review synthesizes research results to assess the effect of traditional Korean medicine (TKM) on HFS in cancer patients.Methods: Four databases (PubMed, The Cochrane Central Register of Controlled Trials, Research Information Sharing Service, China National Knowledge Infrastructure) were searched for randomized controlled trials (RCTs) to assess the effects of TKM on HFS. The effects and quality of RCTs were assessed with the Cochrane risk of bias (ROB) tool.Results: Six RCTs met our study criteria. In all six, TKM showed improvement in HFS symptoms as well as quality of life scores when compared to the control group. However, the methodological quality of RCTs was relatively low due to the unclear or high ROB.Conclusions: TKM would be helpful to patients with HFS after chemotherapy. To clarify the clinical efficacy of TKM, well-designed studies are required in the future.

Pegylated liposomal doxorubicin-induced hand-foot syndrome predicted by serum metabolomic profiling and prevented by calcium dobesilate

Pegylated liposomal doxorubicin-induced hand-foot syndrome predicted by serum metabolomic profiling and prevented by calcium dobesilate

Management of cytotoxic chemotherapy-induced hand-foot syndrome.

Improvements in systemic cancer treatments have resulted in more patients surviving for prolonged periods of time on treatment. This has made treatment-related toxicity and quality of life concerns increasingly relevant. Hand-foot syndrome (HFS) is a common skin reaction to systemic therapy that should be anticipated with chemotherapeutic treatments such as pegylated liposomal doxorubicin, docetaxel, and fluoropyrimidines. In this review we discuss current knowledge of the diagnosis, incidence, pathogenesis, and management of hand-foot syndrome (HFS). Although HFS is not life threatening, it can cause significant discomfort and impairment of function, especially in elderly patients, and may seriously impact quality of life. The incidence of HFS is dependent on the chemotherapeutic drug used, the treatment schedule, and the median duration of treatment. Effective measures for prevention and treatment of HFS include systemic and topical treatments, dose reductions, and switching to other drugs in the same class that are associated with lower rates of HFS. These approaches allow patients to continue cancer treatment while reducing negative impacts on quality of life. Awareness and early recognition are important to ensure timely treatment and avoidance of dose reductions or treatment discontinuation. We provide useful recommendations to guide the management of HFS in clinical practice.

Chemotherapy-induced hand-foot syndrome in rectal cancer treated with acupuncture

ObjectiveTo observe the clinical therapeutic effects of acupuncture on chemotherapy-induced hand-foot syndrome (HFS). MethodsA total of 60 patients treated with chemotherapy of capecitabine and suffering from the chemotherapy-induced HFS were divided into an acupuncture group and a Vitamin B6 group according to the random number table, 30 cases in each one. In the acupuncture group, after chemotherapy, acupuncture was given at Băihuì (百会 GV 20), Hégŭ (合谷 LI 4), Wàiguān (外关 TE 5), Zúsānlĭ (足三里 ST 36) and Ashi points. The needles were retained for 30 min in each treatment, once a day, totally for 2 weeks. In the Vitamin B6 group, after chemotherapy, Vitamin B6 was taken orally, 300 mg a day, totally for 2 weeks. Separately, on the day of enrollment and after 2 weeks of treatment, the scores of Karnofsky performance scale (KPS) and the quality of life (QLQ-C30) were evaluated in the acupuncture group and the Vitamin B6 group. After 2 weeks of treatment, the therapeutic effects were evaluated. ResultsThe effective rate of chemotherapy-induced HFS was 70.0% in the acupuncture group and was 36.7% in the Vitamin B6 group. The result in the acupuncture group was higher than the Vitamin B6 group, indicating the significant difference (P < 0.05). After treatment, the KPS scores (84.23 ± 10.49) in the acupuncture group were higher obviously than the Vitamin B6 group (77.84 ± 10.33), indicating the significant difference (P < 0.05). Regarding QLQ-C30 evaluation, after 2-week treatment, the scores in the items of physical function, role function, emotional function, cognitive function and social function were all reduced remarkably as compared with those before treatment in the two groups, indicating the significant differences (all P < 0.05). After treatment, the scores of physical function (7.13 ± 1.56 vs 16.72 ± 4.29), emotional function (4.89 ± 0.87 vs 11.76 ± 1.29) and cognitive function (6.32 ± 1.23 vs 18.17 ± 4.1) in the acupuncture group were all lower obviously than those in the Vitamin B6 group, indicating the significant differences (all P < 0.05); and the scores of role function and social function were not different significantly as compared with the VB6 group (all P > 0.05). ConclusionAcupuncture is effective for HFS induced by the chemotherapy with capecitabine and its effects are better than the oral administration of Vitamin B 6 in terms of physical function, emotional function and cognitive function.

A Case Report of Chemotherapy-Induced Hand-Foot Syndrome Treated with Modified Dohongsamul-tang

Hand-foot syndrome (HFS) frequently occurs after receiving chemotherapy, such as sorafenib, in patients with hepatocellular carcinoma (HCC), and this impairs quality of life (QOL). The prevalence of HFS due to sorafenib is 10-28%. The effective methods to treat HFS are not established aside from temporary discontinuation of chemotherapy agents and drug dosage adjustment because the mechanism of HFS has not been elucidated. According to a previous study, modified Dohongsamul-tang was effective in the treatment of patients with HFS and improved patients’ QOL. Based on these results, we administered the soaking method with modified Dohongsamul-tang to a 50-year-old male patient with HCC complaining of HFS due to sorafenib. After two weeks, the symptoms of HFS were improved despite taking sorafenib. We suggest that modified Dohongsamul-tang is a novel method for treating HFS. Keywords: hand-foot syndrome, Dohongsamul-tang, sorafenib, medicine, Korean traditional, case reports

Effect of modified Taohongsiwu decoction on patients with chemotherapy-induced hand-foot syndrome

ObjectiveTo observe the effect of the Traditional Chinese Medicine, modified Taohongsiwu decoction, versus pyridoxine on patients with hand-foot syndrome (HFS) from capecitabine, sorafenib, and gefitinib chemotherapy for gastric, lung, breast, colon, or rectal cancer. Also, to compare quality of life of patients in each group. MethodsPatients were assigned randomly to group A or B. Group A was given modified Taohongsiwu decoction to soak hands and feet for 30 min, once daily. Group B was given 100 mg pyridoxine orally, twice daily. After a 2-week treatment, the therapeutic effect was assessed by observing three major symptoms, including pain, ulceration, and muscular atrophy. This was assessed with the HFS-14 questionnaire. ResultsSignificant differences were observed between the two groups in pain relief, and improvement of daily life, walking, and interpersonal communication (P < 0.01). No significant differences in driving ability or interpersonal relationships were found. After 2 weeks, the effective rate was 88.3% in group A, which was significantly higher than the 50% in group B (P=0.00). ConclusionModified Taohongsiwu decoction is effective in the treatment of patients with HFS. It improves patients’ quality of life according to the HFS-14.

Bevacizumab and risk of hand-foot syndrome associated with chemotherapy.

e13591 Background: Hand-foot syndrome (HFS) is a dose-limiting cutaneous side effect of many chemotherapeutic agents. Its pathogenesis and risk factors have not been well understood. In this study, we propose that the inhibition of angiogenesis may contribute to the development of HFS. We investigated the risk of chemotherapy-induced HFS in patients treated with bevacizumab, an angiogenesis inhibitor that is widely used for the treatment of various cancers with a systematic review and a meta-analysis of published randomized-controlled clinical trials (RCTs). Methods: Databases from PUBMED, Cochrane Database, and abstracts presented at the American Society of Clinical Oncology until December, 2011 were searched for the identification of relevant studies. Eligible studies included prospective RCTs in which the addition of bevacizumab to chemotherapy was compared directly to chemotherapy alone in cancer patients. Relative risk (RR), and 95% confidence interval (CI) were calculated using a fixed-or random-effects model based on the heterogeneity of the included studies. Results: A total of six RCTs including 5,043 patients (bevacizumab 2665, control 2378) with a variety of tumors were analyzed. The addition of bevacizumab to chemotherapy significantly increased the risk of developing HFS with an RR of 1.68 (95% CI: 1.17-2.40, p=0.005) in comparison to chemotherapy alone. The risk of HFS significantly increased in patients receiving bevacizumab at 2.5 mg/kg/week (RR of 1.88, 95% CI: 1.39-2.54, p&lt;0.001) and at 5 mg/kg/week (RR of 1.19, 95% CI: 1.03-1.36, p=0.016); however, the increased risk of HFS did not vary significantly with bevacizumab dosage (p=0.72) and with tumor types (p=0.92). The increased risk of HFS varied with concurrent chemotherapeutic agents with a significant difference (p=0.034) between docetaxel (RR 6.94, 95% CI: 1.67-28.81) and 5-FU based agents, including capecitabine (RR 1.25, 95% CI: 1.10-1.42). Conclusions: The risk of HFS associated with chemotherapeutic agents significantly increased with the use of bevacizumab, suggesting an important role of angiogenesis in the development of HFS. Moreover, combination with docetaxel appears to confer a higher risk than 5-FU based agents.

Chemotherapy-induced hand-foot syndrome

Palmar-plantar erythrodyaesthesia is a side effect of some cytotoxic medication, but there is a dearth of research on the specific causes and possible treatments to alleviate symptoms. Tessa Williams explains

Prospective Study of the Cutaneous Adverse Effects of Sorafenib, a Novel Multikinase Inhibitor

To provide an accurate description and to evaluate the incidence and severity of cutaneous reactions induced by sorafenib tosylate, a new oral multikinase inhibitor. Double-blind, prospective dermatologic substudy performed on all consecutive patients included in our center in a large phase 3 trial. Institutional practice at the Gustave Roussy Institute. Eighty-five patients with renal cell cancer treated between November 1, 2003, and February 28, 2005. Interventions Patients were randomized to receive either sorafenib (n = 43) or placebo (n = 42). Dermatologic examination was performed before treatment, every 3 weeks during the first 4 cycles, and every 4 weeks thereafter. Incidence and severity of cutaneous reactions to sorafenib. Thirty-nine patients (91%) experienced at least 1 cutaneous reaction in the sorafenib group vs 3 (7%) in the placebo group. A hand-foot skin reaction that appeared to be clinically distinct from the well-known chemotherapy-induced hand-foot syndrome was observed in 26 patients receiving sorafenib (60%). Reversible grade 3 hand-foot skin reaction was documented in 2 patients receiving sorafenib and led to a dose reduction. Other cutaneous reactions were facial erythema, scalp dysesthesia, alopecia, and subungual splinter hemorrhages. Sorafenib induces frequent cutaneous adverse events, some of which may lead to a dose reduction. Close collaboration between oncologists and dermatologists is needed to improve both the characterization and the management of these side effects. Appropriate patient education before the initiation of therapy and the introduction of early symptomatic measures may improve management.