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Dermatologic Adverse Events to Targeted Therapies in Lower GI Cancers: Clinical Presentation and Management

  • Lower Gastrointestinal Cancers (AB Benson, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Rapid advances in drug discovery and the regulatory approval of a number of novel anticancer agents during the past decade pose unique challenges to the oncology community. While the benefits of such therapies receive most attention, adverse events (AEs), especially those pertaining to subspecialties (e.g., dermatology), often are underemphasized. To ensure best clinical outcomes, it would be important to bridge the gap between approval of a new drug and devising effective management strategies for the AEs. With the incorporation of targeted therapies to the treatment paradigm of gastrointestinal malignancies, there has been a significant rise in dermatologic AEs among those treated. In addition to significantly affecting patients’ quality of life, these AEs represent a growing problem and are relatively unfamiliar to many oncologists. The issue is further complicated by the lack of evidence-based management guidelines for such AEs in the oncology setting, the “generalizing” of terminology (e.g., rash) for some AEs, as well as an insufficient number of oncodermatologists for assistance with their management. It is important for the oncologist to gain familiarity with the most common, manageable and predictable AEs. Their identification is usually based on medical history, clinical features, and full-body skin examination (FBSE) and at times by obtaining a skin biopsy to aid in diagnosis. Although efforts are underway, presently, there is a paucity of biomarkers (e.g., serologic, genetic) to predict dermatologic AEs. Management often requires a multifaceted approach and includes topical, systemic, surgical, and physical (e.g., cryotherapy) modalities of treatment. Unfortunately, very few clinical trials have focused on this aspect of supportive care; therefore, most data on management derives from anecdotal data. Patients should be encouraged to actively report skin problems, while oncologists should play a vital role in addressing these AEs in their patients. Lastly, further research at the molecular and cellular level may assist in the elucidation of the mechanisms underlying these AEs and their clinical correlates, paving way for the design of effective therapies in this subset of patients.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: •Of importance ••Of major importance

  1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v1.2, Cancer incidence and mortality worldwide: IARC CancerBase No. 10 [Internet]. Lyon: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr. Accessed April 1, 2013.

    Google Scholar 

  2. American Cancer Society, Inc. Colorectal Cancer: What are the key statistics about colorectal cancer? 2013. Available from: http://www.cancer.org/cancer/colonandrectumcancer/detailedguide/colorectal-cancer-key-statistics. Accessed on April 1, 2013.

  3. Kabbinavar FF, Schulz J, McCleod M, et al. Addition of bevacizumab to bolus fluorouracil and leucovorin in first-line metastatic colorectal cancer: results of a randomized phase II trial. J Clin Oncol. 2005;23(16):3697–705.

    Article  PubMed  CAS  Google Scholar 

  4. Giantonio BJ, Catalano PJ, Meropol NJ, et al. Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol. 2007;25(12):1539–44.

    Article  PubMed  CAS  Google Scholar 

  5. Van Cutsem E, Peeters M, Siena S, et al. Open-label phase III trial of panitumumab plus best supportive care compared with best supportive care alone in patients with chemotherapy-refractory metastatic colorectal cancer. J Clin Oncol. 2007;25(13):1658–64.

    Article  PubMed  Google Scholar 

  6. Borner M, Koeberle D, Von Moos R, et al. Adding cetuximab to capecitabine plus oxaliplatin (XELOX) in first-line treatment of metastatic colorectal cancer: a randomized phase II trial of the Swiss Group for Clinical Cancer Research SAKK. Ann Oncol. 2008;19(7):1288–92.

    Article  PubMed  CAS  Google Scholar 

  7. Hochster HS, Hart LL, Ramanathan RK, et al. Safety and efficacy of oxaliplatin and fluoropyrimidine regimens with or without bevacizumab as first-line treatment of metastatic colorectal cancer: results of the TREE Study. J Clin Oncol. 2008;26(21):3523–9.

    Article  PubMed  CAS  Google Scholar 

  8. Sobrero AF, Maurel J, Fehrenbacher L, et al. EPIC: phase III trial of cetuximab plus irinotecan after fluoropyrimidine and oxaliplatin failure in patients with metastatic colorectal cancer. J Clin Oncol. 2008;26(14):2311–9.

    Article  PubMed  CAS  Google Scholar 

  9. Grothey A, Van Cutsem E, Sobrero A, et al. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013;381(9863):303–12.

    Article  PubMed  CAS  Google Scholar 

  10. Demetri GD, Reichardt P, Kang YK, et al. Efficacy and safety of regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib (GRID): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013;381(9863):295–302.

    Article  PubMed  CAS  Google Scholar 

  11. Carpenter G, Cohen S. Epidermal growth factor. Annu Rev Biochem. 1979;48:193–216.

    Article  PubMed  CAS  Google Scholar 

  12. Yao M, Shuin T, Misaki H, Kubota Y. Enhanced expression of c-myc and epidermal growth factor receptor (C-erbB-1) genes in primary human renal cancer. Cancer Res. 1988;48(23):6753–7.

    PubMed  CAS  Google Scholar 

  13. Ennis BW, Lippman ME, Dickson RB. The EGF receptor system as a target for antitumor therapy. Cancer Invest. 1991;9(5):553–62.

    Article  PubMed  CAS  Google Scholar 

  14. Albanell J, Rojo F, Averbuch S, et al. Pharmacodynamic studies of the epidermal growth factor receptor inhibitor ZD1839 in skin from cancer patients: histopathologic and molecular consequences of receptor inhibition. J Clin Oncol. 2002;20(1):110–24.

    Article  PubMed  CAS  Google Scholar 

  15. Jost M, Kari C, Rodeck U. The EGF receptor - an essential regulator of multiple epidermal functions. Eur J Dermatol. 2000;10(7):505–10.

    PubMed  CAS  Google Scholar 

  16. Jonker DJ, O'Callaghan CJ, Karapetis CS, et al. Cetuximab for the treatment of colorectal cancer. N Engl J Med. 2007;357(20):2040–8.

    Article  PubMed  CAS  Google Scholar 

  17. Cetuximab [package insert]. Branchburg, NJ: Bristol Myers Squibb Company; 2012 (accessed from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/125084s225lbl.pdf, on April 1, 2013).

  18. Panitumumab [package insert]. Thousand Oaks, CA: Amgen Inc.; 2006–2012. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/125147s0148lbl.pdf. Accessed on April 1, 2013).

  19. Van Doorn R, Kirtschig G, Scheffer E, Stoof TJ, Giaccone G. Follicular and epidermal alterations in patients treated with ZD1839 (Iressa), an inhibitor of the epidermal growth factor receptor. Br J Dermatol. 2002;147(3):598–601.

    Article  PubMed  Google Scholar 

  20. Segaert S, Van Cutsem E. Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors. Ann Oncol. 2005;16(9):1425–33.

    Article  PubMed  CAS  Google Scholar 

  21. Perez-Soler R, Delord JP, Halpern A, et al. HER1/EGFR inhibitor-associated rash: future directions for management and investigation outcomes from the HER1/EGFR inhibitor rash management forum. Oncologist. 2005;10(5):345–56.

    Article  PubMed  CAS  Google Scholar 

  22. Agero AL, Dusza SW, Benvenuto-Andrade C, Busam KJ, Myskowski P, Halpern AC. Dermatologic side effects associated with the epidermal growth factor receptor inhibitors. J Am Acad Dermatol. 2006;55(4):657–70.

    Article  PubMed  Google Scholar 

  23. Perez-Soler R, Saltz L. Cutaneous adverse effects with HER1/EGFR-targeted agents: is there a silver lining? J Clin Oncol. 2005;23(22):5235–46.

    Article  PubMed  Google Scholar 

  24. Van Cutsem E, Kohne CH, Hitre E, et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med. 2009;360(14):1408–17.

    Article  PubMed  Google Scholar 

  25. Luu M, Lai SE, Patel J, Guitart J, Lacouture ME. Photosensitive rash due to the epidermal growth factor receptor inhibitor erlotinib. Photodermatol Photoimmunol Photomed. 2007;23(1):42–5.

    Article  PubMed  Google Scholar 

  26. Jacot W, Bessis D, Jorda E, et al. Acneiform eruption induced by epidermal growth factor receptor inhibitors in patients with solid tumours. Br J Dermatol. 2004;151(1):238–41.

    Article  PubMed  CAS  Google Scholar 

  27. Jatoi A, Green EM, Rowland Jr KM, Sargent DJ, Alberts SR. Clinical predictors of severe cetuximab-induced rash: observations from 933 patients enrolled in north central cancer treatment group study N0147. Oncology. 2009;77(2):120–3.

    Article  PubMed  CAS  Google Scholar 

  28. Lacouture ME. Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer. 2006;6(10):803–12.

    Article  PubMed  CAS  Google Scholar 

  29. Roe E, Garcia Muret MP, Marcuello E, Capdevila J, Pallares C, Alomar A. Description and management of cutaneous side effects during cetuximab or erlotinib treatments: a prospective study of 30 patients. J Am Acad Dermatol. 2006;55(3):429–37.

    Article  PubMed  Google Scholar 

  30. Eilers Jr RE, Gandhi M, Patel JD, et al. Dermatologic infections in cancer patients treated with epidermal growth factor receptor inhibitor therapy. J Natl Cancer Inst. 2010;102(1):47–53.First study that highlighted the increased prevalence of infections, especially bacterial, in patients receiving EGFR inhibitors. Of note, the authors did not find an association between the use of corticosteroids or prophylactic antibiotics (used to treat the EGFR rash) and an increase in the risk of cutaneous infections.

    Article  PubMed  CAS  Google Scholar 

  31. Eames T, Grabein B, Kroth J, Wollenberg A. Microbiological analysis of epidermal growth factor receptor inhibitor therapy-associated paronychia. J Eur Acad Dermatol Venereol. 2010;24(8):958–60.A retrospective study that investigated and summarized the microbial agents associated with the development of paronychia, a nail condition that could potentially affect quality of life in cancer patients treated with EGFR inhibitors. Findings from this study provide justification for empiric antibiotic use to treat such infections.

    Article  PubMed  CAS  Google Scholar 

  32. 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.

    Article  PubMed  Google Scholar 

  33. Ferrara N, Gerber HP, LeCouter J. The biology of VEGF and its receptors. Nat Med. 2003;9(6):669–76.

    Article  PubMed  CAS  Google Scholar 

  34. Di Lorenzo G, Porta C, Bellmunt J, et al. Toxicities of targeted therapy and their management in kidney cancer. Eur Urol. 2011;59(4):526–40.

    Article  PubMed  Google Scholar 

  35. Kabbinavar F, Hurwitz HI, Fehrenbacher L, et al. Phase II, randomized trial comparing bevacizumab plus fluorouracil (FU)/leucovorin (LV) with FU/LV alone in patients with metastatic colorectal cancer. J Clin Oncol. 2003;21(1):60–5.

    Article  PubMed  CAS  Google Scholar 

  36. Bevacizumab [package insert]. South San Francisco, CA: Genentech, Inc.; 2011. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/125085s225lbl.pdf. Accessed on April 1, 2013.

  37. Aflibercept [package insert]. Bridgewater, NJ: Sanofi Aventis US LLC.; 2012. Available from: http://products.sanofi.us/zaltrap/zaltrap.pdf. Accessed on April 1, 2013.

  38. Regorafenib [package insert]. Wayne, NJ: Bayer HealthCare Pharmaceuticals Inc.; 2013 (accessed from: http://labeling.bayerhealthcare.com/html/products/pi/Stivarga_PI.pdf, on Apr 1, 2013).

  39. Ellis LM. Mechanisms of action of bevacizumab as a component of therapy for metastatic colorectal cancer. Semin Oncol. 2006;33(5 Suppl 10):S1–7.

    Article  PubMed  CAS  Google Scholar 

  40. Wozel G, Sticherling M, Schon MP. Cutaneous side effects of inhibition of VEGF signal transduction. J Dtsch Dermatol Ges. 2010;8(4):243–9.

    Article  PubMed  Google Scholar 

  41. Gordon MS, Margolin K, Talpaz M, et al. Phase I safety and pharmacokinetic study of recombinant human anti-vascular endothelial growth factor in patients with advanced cancer. J Clin Oncol. 2001;19(3):843–50.

    PubMed  CAS  Google Scholar 

  42. Chen HX, Gore-Langton RE, Cheson BD. Clinical trials referral resource: Current clinical trials of the anti-VEGF monoclonal antibody bevacizumab. Oncology (Williston Park). 2001;15(8):1017, 1020, 1023–1016.

  43. Pegram MD, Reese DM. Combined biological therapy of breast cancer using monoclonal antibodies directed against HER2/neu protein and vascular endothelial growth factor. Semin Oncol. 2002;29(3 Suppl 11):29–37.

    Article  PubMed  CAS  Google Scholar 

  44. Motl S. Bevacizumab in combination chemotherapy for colorectal and other cancers. Am J Health Syst Pharm. 2005;62(10):1021–32.

    PubMed  CAS  Google Scholar 

  45. Man XY, Yang XH, Cai SQ, et al. Expression and localization of vascular endothelial growth factor and vascular endothelial growth factor receptor-2 in human epidermal appendages: a comparison study by immunofluorescence. Clin Exp Dermatol. 2009;34(3):396–401.

    Article  PubMed  Google Scholar 

  46. Gavrilovic IT, Balagula Y, Rosen AC, et al. Characteristics of oral mucosal events related to bevacizumab treatment. Oncologist. 2012;17(2):274–8.

    Article  PubMed  CAS  Google Scholar 

  47. Belum VR, Wu S, Lacouture ME. Risk of hand-foot skin reaction with the novel multikinase inhibitor regorafenib: a meta-analysis. Invest New Drugs. 2013;31(4):1078–86.

    Google Scholar 

  48. • Nardone B, Hensley JR, Kulik L, et al. The effect of hand-foot skin reaction associated with the multikinase inhibitors sorafenib and sunitinib on health-related quality of life. J Drugs Dermatol. 2012;11(11):e61–5.An important study which showed that the development of hand-foot skin reaction with the VEGF inhibitors sorafenib and sunitinib, negatively impacts patients’ quality of life. The study also found that the NCI-CTCAE grading correlates with health-related quality of life.

    PubMed  Google Scholar 

  49. Jatoi A, Nguyen PL. Do patients die from rashes from epidermal growth factor receptor inhibitors? A systematic review to help counsel patients about holding therapy. Oncologist. 2008;13(11):1201–4.

    Article  PubMed  Google Scholar 

  50. Li T, Perez-Soler R. Skin toxicities associated with epidermal growth factor receptor inhibitors. Target Oncol. 2009;4(2):107–19.

    Article  PubMed  Google Scholar 

  51. Galimont-Collen AF, Vos LE, Lavrijsen AP, Ouwerkerk J, Gelderblom H. Classification and management of skin, hair, nail and mucosal side-effects of epidermal growth factor receptor (EGFR) inhibitors. Eur J Cancer. 2007;43(5):845–51.

    Article  PubMed  CAS  Google Scholar 

  52. Jatoi A. Sunshine and rash: testing the role of sunscreen to prevent epidermal growth factor receptor inhibitor-induced rash. Support Cancer Ther. 2007;4(4):198–202.

    Article  PubMed  CAS  Google Scholar 

  53. Bhojani N, Jeldres C, Patard JJ, et al. Toxicities associated with the administration of sorafenib, sunitinib, and temsirolimus and their management in patients with metastatic renal cell carcinoma. Eur Urol. 2008;53(5):917–30.

    Article  PubMed  CAS  Google Scholar 

  54. Chuang P, Langone AJ. Clobetasol ameliorates aphthous ulceration in renal transplant patients on sirolimus. Am J Transplant. 2007;7(3):714–7.

    Article  PubMed  CAS  Google Scholar 

  55. Robert C, Soria JC, Spatz A, et al. Cutaneous side-effects of kinase inhibitors and blocking antibodies. Lancet Oncol. 2005;6(7):491–500.

    Article  PubMed  CAS  Google Scholar 

  56. Lacouture ME, Wu S, Robert C, et al. Evolving strategies for the management of hand-foot skin reaction associated with the multitargeted kinase inhibitors sorafenib and sunitinib. Oncologist. 2008;13(9):1001–11.

    Article  PubMed  CAS  Google Scholar 

  57. Chu D, Lacouture ME, Fillos T, Wu S. Risk of hand-foot skin reaction with sorafenib: a systematic review and meta-analysis. Acta Oncol. 2008;47(2):176–86.

    Article  PubMed  CAS  Google Scholar 

  58. Scope A, Agero AL, Dusza SW, et al. Randomized double-blind trial of prophylactic oral minocycline and topical tazarotene for cetuximab-associated acne-like eruption. J Clin Oncol. 2007;25(34):5390–6.

    Article  PubMed  CAS  Google Scholar 

  59. Jatoi A, Rowland K, Sloan JA, et al. Tetracycline to prevent epidermal growth factor receptor inhibitor-induced skin rashes: results of a placebo-controlled trial from the North Central Cancer Treatment Group (N03CB). Cancer. 2008;113(4):847–53.

    Article  PubMed  CAS  Google Scholar 

  60. Lacouture ME, Mitchell EP, Piperdi B, et al. Skin toxicity evaluation protocol with panitumumab (STEPP), a phase II, open-label, randomized trial evaluating the impact of a pre-Emptive Skin treatment regimen on skin toxicities and quality of life in patients with metastatic colorectal cancer. J Clin Oncol. 2010;28(8):1351–7.This study investigated the benefit of pre-emptive use of a sunscreen, moisturizer, hydrocortisone 1% cream, and oral doxycycline 100 mg BID in mCRC patients treated with panitumumab. The authors noted a >50% reduction (29% vs 62% in the reactive group) in the incidence of ≥grade 2 rash and a significant delay in its onset, without any additional untoward events.

    Article  PubMed  CAS  Google Scholar 

  61. Jatoi A, Thrower A, Sloan JA, et al. Does sunscreen prevent epidermal growth factor receptor (EGFR) inhibitor-induced rash? Results of a placebo-controlled trial from the North Central Cancer Treatment Group (N05C4). Oncologist. 2010;15(9):1016–22.

    Article  PubMed  Google Scholar 

  62. Jatoi A, Dakhil SR, Sloan JA, et al. Prophylactic tetracycline does not diminish the severity of epidermal growth factor receptor (EGFR) inhibitor-induced rash: results from the North Central Cancer Treatment Group (Supplementary N03CB). Support Care Cancer. 2011;19(10):1601–7.

    Article  PubMed  Google Scholar 

  63. Grande R, Narducci F, Bianchetti S, et al. Pre-emptive skin toxicity treatment for anti-EGFR drugs: evaluation of efficacy of skin moisturizers and lymecycline. A phase II study. Support Care Cancer. Jan 13 2013.

  64. Ren Z, Zhu K, Kang H, et al. A randomized controlled phase II study of the prophylactic effect of urea-based cream on the hand-foot skin reaction associated with sorafenib in advanced hepatocellular carcinoma. J Clin Oncol. 2012;30 (suppl; abstr 4008). A large-scale study, which showed a statistically significant reduction (by 24%) of all grade hand-foot skin reaction in patients prophylactically treated with a urea-based cream.

  65. Scope A, Lieb JA, Dusza SW, et al. A prospective randomized trial of topical pimecrolimus for cetuximab-associated acnelike eruption. J Am Acad Dermatol. 2009;61(4):614–20.

    Article  PubMed  CAS  Google Scholar 

  66. Ocvirk J. Management of cetuximab-induced skin toxicity with the prophylactic use of topical vitamin K1 cream. Radiol Oncol. 2010;44(4):265–6.

    Article  PubMed  Google Scholar 

  67. Perez-Soler R, Zou Y, Li T, Ling YH. The phosphatase inhibitor menadione (vitamin K3) protects cells from EGFR inhibition by erlotinib and cetuximab. Clin Cancer Res. 2011;17(21):6766–77. In this preclinical study, authors demonstrated the ability of menadione (vitamin K3; when applied topically and at nontoxic concentrations), to confer a protective effect on human keratinocytes and abate the EGFR inhibitory effect of erlotinib in skin.

    Article  PubMed  CAS  Google Scholar 

  68. Lopez-Ilasaca M, Schiene C, Kullertz G, Tradler T, Fischer G, Wetzker R. Effects of FK506-binding protein 12 and FK506 on autophosphorylation of epidermal growth factor receptor. J Biol Chem. 1998;273(16):9430–4.

    Article  PubMed  CAS  Google Scholar 

  69. Kanazawa S, Yamaguchi K, Kinoshita Y, Muramatsu M, Komiyama Y, Nomura S. Aspirin reduces adverse effects of gefitinib. Anticancer Drugs. 2006;17(4):423–7.

    Article  PubMed  CAS  Google Scholar 

  70. Kanazawa S, Yamaguchi K, Kinoshita Y, et al. Effect of low-dose aspirin for skin rash associated with erlotinib therapy in patients with lung cancer. Platelets. 2009;20(1):70–1.

    Article  PubMed  CAS  Google Scholar 

  71. Wong SF, Lindgren A, Mummaneni M, et al. A prospective crossover pilot study to evaluate the use of a topical wound gel in patients with cutaneous toxicity caused by epidermal growth factor receptor inhibitors. J Support Oncol. 2010;8(5):202–8.

    Article  PubMed  Google Scholar 

  72. Katzer K, Tietze J, Klein E, Heinemann V, Ruzicka T, Wollenberg A. Topical therapy with nadifloxacin cream and prednicarbate cream improves acneiform eruptions caused by the EGFR-inhibitor cetuximab - A report of 29 patients. Eur J Dermatol. 2010;20(1):82–4.

    PubMed  CAS  Google Scholar 

  73. Onoda T, Ono T, Dhar DK, Yamanoi A, Nagasue N. Tetracycline analogues (doxycycline and COL-3) induce caspase-dependent and -independent apoptosis in human colon cancer cells. Int J Cancer. 2006;118(5):1309–15.

    Article  PubMed  CAS  Google Scholar 

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Memorial Sloan-Kettering Cancer Center

Conflict of Interest

Viswanath Reddy Belum and Virginia Sanz-Motilva declare no conflict of interest.

Andrea Cercek has a consultant/advisory role with and has received honoraria from Bayer.

Mario E. Lacouture has a speaking, consultant or advisory role with Advancell, Amgen, AstraZeneca, Aveo, Bayer, Biopharm Communications, Bristol-Myers Squibb, Clinical Care Options, Envision Communications, Galderma, Genentech, GlaxoSmithKline, Helsinn, Institute for Medical Education and Research, Merck, Novocure, OSI Pharmaceuticals, Permanyer, Pfizer, Sandoz and Sanofi Aventis.

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Authors and Affiliations

  1. Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Rockefeller Outpatient Pavilion, Suite 228, 160 E 53rd St., New York, NY, 10022, USA

    Viswanath Reddy Belum MD & Mario E. Lacouture MD

  2. Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Room H-917, New York, NY, 10065, USA

    Andrea Cercek MD

  3. Department of Dermatology, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n. 28026, Madrid, Spain

    Virginia Sanz-Motilva MD

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Correspondence to Mario E. Lacouture MD.

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Belum, V.R., Cercek, A., Sanz-Motilva, V. et al. Dermatologic Adverse Events to Targeted Therapies in Lower GI Cancers: Clinical Presentation and Management. Curr. Treat. Options in Oncol. 14, 389–404 (2013). https://doi.org/10.1007/s11864-013-0254-4

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