Der Internist

, 52:1359

Neue Tyrosinkinase- und EGFR-Inhibitoren in der Tumortherapie

Herz und Haut als wichtige Schädigungsorgane. Teil B: Haut
Arzneimitteltherapie

Zusammenfassung

In den letzen Jahren konnten mehrere neue Substanzklassen erfolgreich zur Therapie solider Tumoren etabliert werden: monoklonale, gegen den epidermalen Wachstumsfaktorrezeptor (EGFR) gerichtete Antikörper, Inhibitoren der EGFR-abhängigen Tyrosinkinase und Multityrosinkinaseinhibitoren. Diese Substanzen greifen selektiv in gestörte Regulationsvorgänge maligner Zellen ein und weisen im Vergleich zu konventionellen Chemotherapeutika ein grundsätzlich anderes Nebenwirkungsprofil auf. Als bedeutendste Nebenwirkungen der gegen den EGFR gerichteten Therapien gelten vielfältige kutane Reaktionen, die behandlungszeitabhängig in substanzklassenspezifischen Mustern auftreten. Diese umfassen bei EGFR-Inhibitoren akneiforme Exantheme, schmerzhafte Paronychien, Xerosis cutis, akrale Rhagaden, Haarveränderungen und Pruritus. Tyrosinkinaseinhibitoren können ein Hand-Fuß-Syndrom, makulopapulöse Exantheme, Effluvium, Xerosis cutis und Pruritus auslösen. Diese häufig stigmatisierenden Nebenwirkungen beeinträchtigen die Lebensqualität der Patienten nachhaltig und stellen daher eine große therapeutische Herausforderung dar. Eine optimale Therapie ist nach unserer Erfahrung nur bei guter interdisziplinärer Zusammenarbeit von Dermatologen und Onkologen möglich.

Schlüsselwörter

Zielgerichtete Therapie Epidermaler Wachstumsfaktor-Hemmer Multikinaseinhibitor Hautnebenwirkungen Kutane Reaktionsmuster 

New tyrosine kinase and EGFR inhibitors in cancer therapy

Cardiac and skin toxicity as relevant side effects. Part B: skin

Abstract

Recently, inhibitors of the epidermal growth factor receptor (EGFR) and multikinase inhibitors have been successfully established in the therapy of various solid tumors. EGFR inhibitors and multikinase inhibitors are specific and selective agents that intervene with the dysfunctional regulatory processes of malignant cells. This results in a favorable safety profile and range of side effects, especially in comparison to conventional chemotherapy. The various cutaneous adverse drug reactions are considered substance class effects and are the most frequent side effects of these targeted therapies. Therapy with EGFR inhibitors is associated with acneiform rash, painful paronychia, xerosis cutis, acral fissures, hair changes, and pruritus. Treatment with tyrosin kinase inhibitors may cause hand-foot syndrome, various types of drug rash, hair loss, xerosis cutis, and pruritus. These side effects may be stigmatizing and place a huge burden on the patient’s quality of life. Treatment is a challenge and best performed in interdisciplinary cooperation of dermatologists and oncologists.

Keywords

Targeted therapy Epidermal growth factor inhibitor Multikinase inhibitor Skin side effects Cutaneous reactive patterns 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Klinik für Dermatologie und AllergologieLudwig-Maximilians-Universität MünchenMünchenDeutschland
  2. 2.Medizinische Klinik III, Klinikum GroßhadernLudwig-Maximilians-Universität MünchenMünchenDeutschland

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