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

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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.

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Acknowledgments

This project and the authors were supported by a grant from Amgen France. We are grateful to the members of Laboratoires Amgen France for their support and to the experts whose knowledge and experience were crucial to the development of these recommendations. Thanks to the Regional experts groups “PROCUR” E. Achille, C. Borel, C. de la Fouchardière, P. Giraud, C. Lebbe, M.T. Leccia, L. Mortier, G. Reuter, J.P. Wagner.

Author information

Authors and Affiliations

  1. Department of Dermatology, CHU Reims, Hôpital Robert Debré, avenue du Général Koenig, 51092, Reims, France

    Z. Reguiai

  2. Department of Hepato-Gastro-Enterology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France

    J. B. Bachet

  3. Department of Internal Medicine, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France

    C. Bachmeyer

  4. Department of Dermatology-Oncology, CHU Hôtel Dieu, Nantes, France

    L. Peuvrel & B. Dreno

  5. Department of Dermatology, Hôpital du Haut Lévêque, CHU Bordeaux, Pessac, France

    M. Beylot-Barry

  6. Department of Dermatology-Venerology, Hôpital Saint Louis, Paris, France

    M. Bezier

  7. Department of Medical Oncology, Centre Régional de Lutte contre le Cancer Eugène Marquis, Rennes, France

    E. Boucher

  8. Department of Radiotherapy, Clinique Pasteur, Toulouse, France

    C. Chevelle

  9. Department of Oncology Radiotherapy, Polyclinique Courlancy, Reims, France

    P. Colin

  10. Department of Gastro-Enterology, Hôpital de Rangueil, Toulouse, France

    R. Guimbaud

  11. Department of Oncology Radiotherapy, Institut Sainte Catherine, Avignon, France

    L. Mineur

  12. Department of Dermatology, CHU Timone, Assistance Publique des Hopitaux de Marseille, Marseille, France

    M. A. Richard

  13. Department of Internal Medicine—Oncology, Hôpital Privé Jean Mermoz, Lyon, France

    P. Artru

  14. Centre Régional de Lutte Contre le Cancer, Centre Paul Strauss, Strasbourg, France

    P. Dufour

  15. Department of Hepato-Gastro-Enterology, Hôpital Saint Louis, Paris, France

    J. M. Gornet

  16. Centre Régional de Lutte contre le Cancer Val d’Aurelle, Montpellier, France

    E. Samalin

  17. Radiation Oncology Department, Poitiers University Hospital and Faculty of Medicine, 2 rue de la Milétrie, BP 577, 86021, Poitiers Cedex, France

    R. J. Bensadoun

  18. Centre Régional de Lutte Contre le Cancer Val d’Aurelle, Montpellier, France

    M. Ychou

  19. Department of Medical Oncology, Hôpital St. Antoine, Assistance Publique—Hôpitaux de Paris, Paris, France

    T. André

  20. Department of Hepato-Gastro-Enterology and Gastro-Intestinal Oncology, CHU Reimsn, Reims, France

    O. Bouché

Authors
  1. Z. Reguiai
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  2. J. B. Bachet
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  3. C. Bachmeyer
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  4. L. Peuvrel
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  5. M. Beylot-Barry
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  6. M. Bezier
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  7. E. Boucher
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  8. C. Chevelle
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  9. P. Colin
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  10. R. Guimbaud
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  11. L. Mineur
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  12. M. A. Richard
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  13. P. Artru
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  14. P. Dufour
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  15. J. M. Gornet
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  16. E. Samalin
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  17. R. J. Bensadoun
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  18. M. Ychou
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  19. T. André
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  20. B. Dreno
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  21. O. Bouché
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Corresponding author

Correspondence to Z. Reguiai.

Additional information

B. Dreno For equal work of the last author.

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Reguiai, Z., Bachet, J.B., Bachmeyer, C. et al. Management of cutaneous adverse events induced by anti-EGFR (epidermal growth factor receptor): a French interdisciplinary therapeutic algorithm. Support Care Cancer 20, 1395–1404 (2012). https://doi.org/10.1007/s00520-012-1451-6

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  • DOI: https://doi.org/10.1007/s00520-012-1451-6

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