Opinion statement
In recent years, oncogene-directed targeted agents and immunotherapies have expanded the treatment armamentarium for advanced lung cancer and, in particular, non-small cell lung cancer (NSCLC). Along with extended survival, these agents are accompanied by a host of cutaneous complications that affect the skin, hair, and nails. These skin complications range from the well-characterized papulopustular (acneiform) eruption of the epidermal growth factor receptor (EGFR) inhibitors to the emerging characterization of lichenoid skin eruptions seen during treatment with antibodies targeting the programmed cell death protein 1 (PD-1) and programmed cell death protein 1 ligand (PD-L1). When promptly recognized and accurately diagnosed, most cutaneous adverse events can be managed with supportive treatments, avoiding the need to interrupt antitumor therapy. Furthermore, preemptive management of skin problems can lead to significantly decreased severity of many cutaneous complications of these therapies. We encourage close collaboration between dermatologists and oncologists to better characterize cutaneous toxicity, select appropriate management, and avoid unnecessary dose reduction or discontinuation while simultaneously improving patient quality of life.
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Silvina B. Pugliese and Bernice Y. Kwong declare that they have no conflict of interest. Joel W. Neal has served as a consultant and/or advisory for Clovis Oncology, CARET/Physicians Resource Management, and Nektar Therapeutics, and has received research funding through grants from Genentech/Roche, Merck, ArQule, Novartis, Exelixis, Boehringer Ingelheim, and Nektar Therapeutics.
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Pugliese, S.B., Neal, J.W. & Kwong, B.Y. Management of Dermatologic Complications of Lung Cancer Therapies. Curr. Treat. Options in Oncol. 16, 50 (2015). https://doi.org/10.1007/s11864-015-0368-y
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DOI: https://doi.org/10.1007/s11864-015-0368-y
Keywords
- Oncodermatology
- Skin toxicity
- Lung cancer
- Epidermal growth factor receptor inhibitor
- Vascular endothelial growth factor inhibitor
- Anaplastic kinase lymphoma inhibitor
- Programmed cell death protein 1
- PD-1
- BRAF inhibitor
- Immunotherapy
- Checkpoint inhibitor
- Papulopustular eruption
- Xerosis
- Pruritus
- Paronychia
- Pyogenic granuloma
- Photosensitivity
- Pruritus
- Hair
- Nails
- Rash