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Published in: Dermatology and Therapy 1/2017

Open Access 01-03-2017 | Original Research

Cutaneous Side Effects and Transepidermal Water Loss To Gefitinib: A Study of 11 Patients

Authors: Franky Chandra, Dendi Sandiono, Unwati Sugiri, Oki Suwarsa, Hendra Gunawan

Published in: Dermatology and Therapy | Issue 1/2017

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Abstract

Introduction

Cutaneous side effects caused by epidermal growth factor receptor (EGFR) inhibitors occurred in 45–100% of patients which may lead to therapy modification or interruption. This study aimed to evaluate cutaneous side effects and transepidermal water loss (TEWL) values in non-small cell lung carcinoma (NSCLC) patients who received gefitinib EGFR inhibitor.

Methods

A descriptive observational study with cross-sectional design and a consecutive sampling method was conducted from 1 February to 4 March 2016. Eleven NSCLC patients with EGFR mutation who visited the Hemato-Oncology Clinic/Internal Medicine Department, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, were assessed through history taking, physical examination, and TEWL examination using Tewameter.

Results

Ten of the eleven patients experienced cutaneous side effects. The most frequently observed was xerosis cutis (8/10 patients), followed by acneiform eruptions (7/10 patients), and paronychia (3/10 patients). None of these patients experienced hair changes, mucositis, or drug hypersensitivity. Mean TEWL value of these patients was higher than normal (11.205 ± 1.881 g/m2/h).

Conclusions

Patients who received gefitinib EGFR inhibitor experienced cutaneous side effects including xerosis cutis, acneiform eruptions, and paronychia, and have mean TEWL values higher than normal. Therefore, it might affect the skin barrier function.
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Literature
1.
go back to reference Keefe DMK, Bateman EH. Tumor control versus adverse events with targeted anticancer therapies. Nat Rev Clin Oncol. 2012;9:98–109.CrossRef Keefe DMK, Bateman EH. Tumor control versus adverse events with targeted anticancer therapies. Nat Rev Clin Oncol. 2012;9:98–109.CrossRef
2.
go back to reference Reck M, Gatzemeier U. Gefitinib (‘Iressa’):a new therapy for advanced non-small-cell lung cancer. Respir Med. 2005;99:298–307.CrossRefPubMed Reck M, Gatzemeier U. Gefitinib (‘Iressa’):a new therapy for advanced non-small-cell lung cancer. Respir Med. 2005;99:298–307.CrossRefPubMed
5.
go back to reference Santiago F, Reis JP, Gonçalo M, Figueiredo A. Adverse cutaneous reactions to epidermal growth factor receptor inhibitors-a study of 14 patients. An Bras Dermatol. 2011;86(3):483–90.CrossRefPubMed Santiago F, Reis JP, Gonçalo M, Figueiredo A. Adverse cutaneous reactions to epidermal growth factor receptor inhibitors-a study of 14 patients. An Bras Dermatol. 2011;86(3):483–90.CrossRefPubMed
6.
go back to reference Eaby B, Culkin A, Lacouture ME. An interdisciplinary consensus on managing skin reactions associated with human epidermal growth factor receptor inhibitors. Clin J Oncol Nurs. 2008;12(2):283–90.CrossRefPubMed Eaby B, Culkin A, Lacouture ME. An interdisciplinary consensus on managing skin reactions associated with human epidermal growth factor receptor inhibitors. Clin J Oncol Nurs. 2008;12(2):283–90.CrossRefPubMed
7.
go back to reference Giovanini M, et al. Clinical significance of skin toxicity due to EGFR-targeted therapies. J Oncol. 2009;30:1–8.CrossRef Giovanini M, et al. Clinical significance of skin toxicity due to EGFR-targeted therapies. J Oncol. 2009;30:1–8.CrossRef
8.
go back to reference Kitamura H, Yazawa T, Okudela K, Shimoyamada H, Sato H. Molecular and genetic pathogenesis of lung cancer:differences between small-cell and non-small-cell carcinomas. Open Pathol J. 2008;2:106–14.CrossRef Kitamura H, Yazawa T, Okudela K, Shimoyamada H, Sato H. Molecular and genetic pathogenesis of lung cancer:differences between small-cell and non-small-cell carcinomas. Open Pathol J. 2008;2:106–14.CrossRef
10.
go back to reference Diaz A, Lage A. Therapies based on inhibitors of the epidermal growth factor receptor:reaching for the future. Biotecnol Apl. 2007;24:10–8. Diaz A, Lage A. Therapies based on inhibitors of the epidermal growth factor receptor:reaching for the future. Biotecnol Apl. 2007;24:10–8.
11.
go back to reference Heidary N, Naik H, Burgin S. Chemotherapeutic agents and the skin:an update. J Am Acad Dermatol. 2008;58:545–70.CrossRefPubMed Heidary N, Naik H, Burgin S. Chemotherapeutic agents and the skin:an update. J Am Acad Dermatol. 2008;58:545–70.CrossRefPubMed
12.
go back to reference Cohen EEW, et al. Phase II trial of gefitinib 250 mg daily in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck. Clin Cancer Res. 2005;11(23):8418–24.CrossRefPubMed Cohen EEW, et al. Phase II trial of gefitinib 250 mg daily in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck. Clin Cancer Res. 2005;11(23):8418–24.CrossRefPubMed
13.
go back to reference Lynch TJ, et al. Epidermal growth factor receptor inhibitor-associated cutaneous toxicities: an evolving paradigm in clinical management. Oncol. 2007;12:610–21.CrossRef Lynch TJ, et al. Epidermal growth factor receptor inhibitor-associated cutaneous toxicities: an evolving paradigm in clinical management. Oncol. 2007;12:610–21.CrossRef
14.
go back to reference Lacouture ME. Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer. 2006;6:803–12.CrossRefPubMed Lacouture ME. Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer. 2006;6:803–12.CrossRefPubMed
15.
go back to reference Burtness B, Goldwasser MA, Flood W, Mattar B, Forastiere AA. Phase III randomized trial of cisplatin plus placebocompared with cisplatin plus cetuximab in metastatic recurrent head and neck cancer: an eastern cooperative oncology group study. J Clin Oncol. 2005;23:8646–54.CrossRefPubMed Burtness B, Goldwasser MA, Flood W, Mattar B, Forastiere AA. Phase III randomized trial of cisplatin plus placebocompared with cisplatin plus cetuximab in metastatic recurrent head and neck cancer: an eastern cooperative oncology group study. J Clin Oncol. 2005;23:8646–54.CrossRefPubMed
16.
go back to reference Han SS, et al. Investigation of papulopustular eruptions caused by cetuximab treatment shows altered differentiation markers and increases in inflammatory cytokines. Br J Dermatol. 2010;162:371–9.CrossRefPubMed Han SS, et al. Investigation of papulopustular eruptions caused by cetuximab treatment shows altered differentiation markers and increases in inflammatory cytokines. Br J Dermatol. 2010;162:371–9.CrossRefPubMed
17.
go back to reference Wang S, et al. Skin manifestations of gefitinib and the association with survival of advanced non-small-cell lung cancer in Taiwan. Dermatol Sin. 2011;29:13–8.CrossRef Wang S, et al. Skin manifestations of gefitinib and the association with survival of advanced non-small-cell lung cancer in Taiwan. Dermatol Sin. 2011;29:13–8.CrossRef
18.
go back to reference Araki T, et al. Review of the treatment of non-small cell lung cancer with gefitinib. Clin Med Insight:Oncol. 2012;6:407–21.CrossRef Araki T, et al. Review of the treatment of non-small cell lung cancer with gefitinib. Clin Med Insight:Oncol. 2012;6:407–21.CrossRef
19.
go back to reference Verdier-Sévrain S, Bonté F. Skin hydration:a review on its molecular mechanisms. J Cosmet Dermatol. 2007;6:75–82.CrossRefPubMed Verdier-Sévrain S, Bonté F. Skin hydration:a review on its molecular mechanisms. J Cosmet Dermatol. 2007;6:75–82.CrossRefPubMed
20.
go back to reference Roe E, et al. Description and management of cutaneous side effects during cetuximab or erlotinib treatments: a prospective study of 30 patients. J Am Acad Dermatol. 2006;55:429–37.CrossRefPubMed Roe E, et al. Description and management of cutaneous side effects during cetuximab or erlotinib treatments: a prospective study of 30 patients. J Am Acad Dermatol. 2006;55:429–37.CrossRefPubMed
21.
go back to reference Balagula Y, Lacouture ME, Cotliar JA. Dermatologic toxicities of targeted anticancer therapies. J Support Oncol. 2010;8:149–61.CrossRefPubMed Balagula Y, Lacouture ME, Cotliar JA. Dermatologic toxicities of targeted anticancer therapies. J Support Oncol. 2010;8:149–61.CrossRefPubMed
22.
go back to reference Shah SR, Walsh TL, Williams CB, Soefje SA. Gefitinib (ZD1839, Iressa®):a selective epidermal growth factor receptor-tyrosine kinase inhibitor. J Oncol Pharm Pract. 2003;9:151–60.CrossRef Shah SR, Walsh TL, Williams CB, Soefje SA. Gefitinib (ZD1839, Iressa®):a selective epidermal growth factor receptor-tyrosine kinase inhibitor. J Oncol Pharm Pract. 2003;9:151–60.CrossRef
23.
go back to reference Guttman-Yassky E, et al. Characterisation of the cutaneous pathology in non-small cell lung cancer (NSCLC) patients treated with the EGFR tyrosine kinase inhibitor erlotinib. Eur J Cancer. 2010;46:2010–9.CrossRefPubMed Guttman-Yassky E, et al. Characterisation of the cutaneous pathology in non-small cell lung cancer (NSCLC) patients treated with the EGFR tyrosine kinase inhibitor erlotinib. Eur J Cancer. 2010;46:2010–9.CrossRefPubMed
24.
go back to reference Abdullah SE, Haigentz Jr M., Piperdi B. Dermatologic toxicities from monoclonal antibodies and tyrosine kinase inhibitors against EGFR: pathophysiology and management. Dermatol Res Pract. 2012:1–10. Abdullah SE, Haigentz Jr M., Piperdi B. Dermatologic toxicities from monoclonal antibodies and tyrosine kinase inhibitors against EGFR: pathophysiology and management. Dermatol Res Pract. 2012:1–10.
25.
go back to reference Seagert S, Custom VE. Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors. Ann Oncol. 2005;16(9):1425–33.CrossRef Seagert S, Custom VE. Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors. Ann Oncol. 2005;16(9):1425–33.CrossRef
26.
go back to reference Fabbrocini G, et al. Chemotherapy and skin reactions. J Exp Clin Canc Res. 2012;31:50–6.CrossRef Fabbrocini G, et al. Chemotherapy and skin reactions. J Exp Clin Canc Res. 2012;31:50–6.CrossRef
27.
go back to reference Plessis J. International guidelines for the in vivo assessment of skin properties in non-clinical settings:part 2. Transepidermal water loss and skin hydration. Skin Res Technol. 2013;19:265–78.CrossRefPubMedPubMedCentral Plessis J. International guidelines for the in vivo assessment of skin properties in non-clinical settings:part 2. Transepidermal water loss and skin hydration. Skin Res Technol. 2013;19:265–78.CrossRefPubMedPubMedCentral
28.
go back to reference Jacobi U, Gautier J, Sterry W, Lademann J. Gender-related differences in the physiology of the stratum corneum. Dermatology. 2005;211:312–7.CrossRefPubMed Jacobi U, Gautier J, Sterry W, Lademann J. Gender-related differences in the physiology of the stratum corneum. Dermatology. 2005;211:312–7.CrossRefPubMed
29.
go back to reference Kleesz P, Darlenski R, Fluhr JW. Full-body skin mapping for six biophysical parameters: baseline values at 16 anatomical sites in 125 human subjects. Skin Pharmacol Physiol. 2012;25:25–33.CrossRefPubMed Kleesz P, Darlenski R, Fluhr JW. Full-body skin mapping for six biophysical parameters: baseline values at 16 anatomical sites in 125 human subjects. Skin Pharmacol Physiol. 2012;25:25–33.CrossRefPubMed
30.
go back to reference Reed JT, Ghadially R, Elias PM. Skin type, but neither race nor gender, influence epidermal permeability barrier function. Arch Dermatol. 1995;131:1134–8.CrossRefPubMed Reed JT, Ghadially R, Elias PM. Skin type, but neither race nor gender, influence epidermal permeability barrier function. Arch Dermatol. 1995;131:1134–8.CrossRefPubMed
Metadata
Title
Cutaneous Side Effects and Transepidermal Water Loss To Gefitinib: A Study of 11 Patients
Authors
Franky Chandra
Dendi Sandiono
Unwati Sugiri
Oki Suwarsa
Hendra Gunawan
Publication date
01-03-2017
Publisher
Springer Healthcare
Published in
Dermatology and Therapy / Issue 1/2017
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI
https://doi.org/10.1007/s13555-016-0163-0

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