Supportive Care in Cancer

, Volume 20, Issue 7, pp 1395–1404

Management of cutaneous adverse events induced by anti-EGFR (epidermal growth factor receptor): a French interdisciplinary therapeutic algorithm

  • Z. Reguiai
  • J. B. Bachet
  • C. Bachmeyer
  • L. Peuvrel
  • M. Beylot-Barry
  • M. Bezier
  • E. Boucher
  • C. Chevelle
  • P. Colin
  • R. Guimbaud
  • L. Mineur
  • M. A. Richard
  • P. Artru
  • P. Dufour
  • J. M. Gornet
  • E. Samalin
  • R. J. Bensadoun
  • M. Ychou
  • T. André
  • B. Dreno
  • O. Bouché
Review Article

DOI: 10.1007/s00520-012-1451-6

Cite this article as:
Reguiai, Z., Bachet, J.B., Bachmeyer, C. et al. Support Care Cancer (2012) 20: 1395. doi:10.1007/s00520-012-1451-6

Abstract

Purpose

Cutaneous adverse events induced by epidermal growth factor receptor (EGFR) inhibitors can hamper the patients' quality of life. The aim of our work was to draft an algorithm for the optimised management of this skin toxicity.

Methods

This algorithm was built in three steps under the responsibility of a steering committee. Step I: a systematic literature analysis (SLA) has been performed. Step II: the collection of information about practices was performed through a questionnaire.These questions were asked during regional meetings to which oncologists, gastro-enterologists, radiotherapists, and dermatologists were invited. Step III: a final meeting was organised involving the bibliography group and the steering committee and regional scientific committees for proposing a final algorithm.

Results

Step I: 14 publications were selected to evaluate the use of cyclines as curative or prophylactic treatment of the folliculitis induced by EGFR inhibitors. Nineteen publications were retained for the topical treatment of the folliculitis. Forty-six articles were selected for the management of the cutaneous lesions in link with appendages and 12 for xerosis and pruritus. Step II: 96 delegates attended the seven regional meetings and 67 questionnaires were analysed. Step III: a final algorithm was proposed on the basis of the conclusions of the first two steps and expert opinions present at this final meeting. The different propositions were unanimously approved by the 14 experts who voted.

Conclusions

This multidisciplinary study summarising published data and current practices produced a therapeutic algorithm, which should facilitate the standardised, optimised management of skin toxicity associated with EGFR inhibitors in France.

Keywords

Epidermal growth factor receptor inhibitors Cetuximab Panitumumab Erlotinib Gefitinib Drug eruption Paronychia Pruritus 

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Z. Reguiai
    • 1
  • J. B. Bachet
    • 2
  • C. Bachmeyer
    • 3
  • L. Peuvrel
    • 4
  • M. Beylot-Barry
    • 5
  • M. Bezier
    • 6
  • E. Boucher
    • 7
  • C. Chevelle
    • 8
  • P. Colin
    • 9
  • R. Guimbaud
    • 10
  • L. Mineur
    • 11
  • M. A. Richard
    • 12
  • P. Artru
    • 13
  • P. Dufour
    • 14
  • J. M. Gornet
    • 15
  • E. Samalin
    • 16
  • R. J. Bensadoun
    • 17
  • M. Ychou
    • 18
  • T. André
    • 19
  • B. Dreno
    • 4
  • O. Bouché
    • 20
  1. 1.Department of DermatologyCHU Reims, Hôpital Robert DebréReimsFrance
  2. 2.Department of Hepato-Gastro-Enterology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de ParisParisFrance
  3. 3.Department of Internal MedicineHôpital Tenon, Assistance Publique-Hôpitaux de ParisParisFrance
  4. 4.Department of Dermatology-OncologyCHU Hôtel DieuNantesFrance
  5. 5.Department of DermatologyHôpital du Haut Lévêque, CHU BordeauxPessacFrance
  6. 6.Department of Dermatology-VenerologyHôpital Saint LouisParisFrance
  7. 7.Department of Medical OncologyCentre Régional de Lutte contre le Cancer Eugène MarquisRennesFrance
  8. 8.Department of RadiotherapyClinique PasteurToulouseFrance
  9. 9.Department of Oncology RadiotherapyPolyclinique CourlancyReimsFrance
  10. 10.Department of Gastro-EnterologyHôpital de RangueilToulouseFrance
  11. 11.Department of Oncology RadiotherapyInstitut Sainte CatherineAvignonFrance
  12. 12.Department of DermatologyCHU Timone, Assistance Publique des Hopitaux de MarseilleMarseilleFrance
  13. 13.Department of Internal Medicine—OncologyHôpital Privé Jean MermozLyonFrance
  14. 14.Centre Régional de Lutte Contre le CancerCentre Paul StraussStrasbourgFrance
  15. 15.Department of Hepato-Gastro-EnterologyHôpital Saint LouisParisFrance
  16. 16.Centre Régional de Lutte contre le Cancer Val d’AurelleMontpellierFrance
  17. 17.Radiation Oncology DepartmentPoitiers University Hospital and Faculty of MedicinePoitiers CedexFrance
  18. 18.Centre Régional de Lutte Contre le Cancer Val d’AurelleMontpellierFrance
  19. 19.Department of Medical OncologyHôpital St. Antoine, Assistance Publique—Hôpitaux de ParisParisFrance
  20. 20.Department of Hepato-Gastro-Enterology and Gastro-Intestinal OncologyCHU ReimsnReimsFrance