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Vol.6 , No. 4, Publication Date: Aug. 22, 2019, Page: 31-38
 participants were categorized as pre-emptive treaters. A higher proportion of pre-emptive treaters than reactive treaters recommended every one of the specific management strategies that were assessed in the survey, including: skin moisturizer (78% vs. 58%; p<0.001), sunscreen (75% vs. 57%; p=0.002), over-the-counter (OTC) topical steroids (42% vs. 37%; p=0.27), prescription strength topical steroids (30% vs 30%; p=0.95), topical antibiotics (37% vs. 26%; p=0.001), oral antibiotics (39% vs. 26%; 0.006), and UV protective garments (61% vs. 47%; p=0.008). Conclusions: Our results clearly illustrate the urgent need for heightened education among oncologists who treat mCRC patients with panitumumab. Several management strategies, such as moisturizer, sunscreen, and UV protective garments, are easily implemented and should be recommended to 100% of mCRC patients who receive panitumumab.&picture=http://www.aascit.org/aascit/decorators/img/journal/906.jpg)
| [1] | Kimberly Lowe, Amgen, Inc, Thousand Oaks, California, USA. |
| [2] | Laura Sangaré, SimulStat, Portland, Oregon, USA. |
| [3] | Rachel Bergstresser, Adelphi Research, Doylestown, Pennsylvania, USA. |
| [4] | Kristina Hool, Amgen, Inc, Thousand Oaks, California, USA. |
| [5] | George Kafatos, Amgen, Ltd, United Kingdom. |
| [6] | Michelle McNamara, Adelphi Research, Doylestown, Pennsylvania, USA. |
| [7] | Tamer Garawin, Amgen, Inc, Thousand Oaks, California, USA. |
Background: The study aimed to assess oncologist’s opinions and perceptions regarding the management of dermatologic toxicity among the patients they treat with panitumumab, with specific emphasis on the timing of rash management. Methods: A survey was developed in September 2016 based on the current literature and expert opinions regarding the management of dermatologic toxicities. Eligible oncologists were board certified and had treated at least five new or continuing patients with mCRC in the last three months, with at least three patients who received or were currently receiving panitumumab. Pre-emptive treaters were defined as those who reported treating≥50% of their panitumumab-treated patients prior to the onset of rash. The remaining oncologists were categorized as reactive treaters. Results: Among the 250 oncologists who completed the survey, 139 (56%) participants were categorized as pre-emptive treaters. A higher proportion of pre-emptive treaters than reactive treaters recommended every one of the specific management strategies that were assessed in the survey, including: skin moisturizer (78% vs. 58%; p<0.001), sunscreen (75% vs. 57%; p=0.002), over-the-counter (OTC) topical steroids (42% vs. 37%; p=0.27), prescription strength topical steroids (30% vs 30%; p=0.95), topical antibiotics (37% vs. 26%; p=0.001), oral antibiotics (39% vs. 26%; 0.006), and UV protective garments (61% vs. 47%; p=0.008). Conclusions: Our results clearly illustrate the urgent need for heightened education among oncologists who treat mCRC patients with panitumumab. Several management strategies, such as moisturizer, sunscreen, and UV protective garments, are easily implemented and should be recommended to 100% of mCRC patients who receive panitumumab.
Keywords
Anti-EGFR, Panitumumab, Dermatologic Toxicity, Anceniform Rash, Metastatic Colorectal Cancer (mCRC)
Reference
| [01] | Modulation of fluorouracil by leucovorin in patients with advanced colorectal cancer: evidence in terms of response rate. Advanced Colorectal Cancer Meta-Analysis Project. J Clin Oncol. 1992; 10 (6): 896-903. doi: 10.1200/JCO.1992.10.6.896. PubMed PMID: 1534121. |
| [02] | Goldberg RM, Rothenberg ML, Van Cutsem E, Benson AB, 3rd, Blanke CD, Diasio RB, et al. The continuum of care: a paradigm for the management of metastatic colorectal cancer. Oncologist. 2007; 12 (1): 38-50. doi: 10.1634/theoncologist.12-1-38. PubMed PMID: 17227899. |
| [03] | Loupakis F, Cremolini C, Masi G, Lonardi S, Zagonel V, Salvatore L, et al. Initial therapy with FOLFOXIRI and bevacizumab for metastatic colorectal cancer. N Engl J Med. 2014; 371 (17): 1609-18. doi: 10.1056/NEJMoa1403108. PubMed PMID: 25337750. |
| [04] | Carrato A, Abad A, Massuti B, Gravalos C, Escudero P, Longo-Munoz F, et al. First-line panitumumab plus FOLFOX4 or FOLFIRI in colorectal cancer with multiple or unresectable liver metastases: A randomised, phase II trial (PLANET-TTD). Eur J Cancer. 2017; 81: 191-202. doi: 10.1016/j.ejca.2017.04.024. PubMed PMID: 28633089. |
| [05] | Rivera F, Karthaus M, Hecht JR, Sevilla I, Forget F, Fasola G, et al. Final analysis of the randomised PEAK trial: overall survival and tumour responses during first-line treatment with mFOLFOX6 plus either panitumumab or bevacizumab in patients with metastatic colorectal carcinoma. Int J Colorectal Dis. 2017; 32 (8): 1179-90. doi: 10.1007/s00384-017-2800-1. PubMed PMID: 28424871; PubMed Central PMCID: PMCPMC5522523. |
| [06] | Moorcraft SY, Smyth EC, Cunningham D. The role of personalized medicine in metastatic colorectal cancer: an evolving landscape. Therap Adv Gastroenterol. 2013; 6 (5): 381-95. doi: 10.1177/1756283X13491797. PubMed PMID: 24003339; PubMed Central PMCID: PMC3756633. |
| [07] | Boone SL, Rademaker A, Liu D, Pfeiffer C, Mauro DJ, Lacouture ME. Impact and management of skin toxicity associated with anti-epidermal growth factor receptor therapy: survey results. Oncology. 2007; 72 (3-4): 152-9. doi: 10.1159/000112795. PubMed PMID: 18160805. |
| [08] | Fakih M, Vincent M. Adverse events associated with anti-EGFR therapies for the treatment of metastatic colorectal cancer. Curr Oncol. 2010; 17 Suppl 1: S18-30. PubMed PMID: 20680104; PubMed Central PMCID: PMCPMC2901793. |
| [09] | Wagner LI, Lacouture ME. Dermatologic toxicities associated with EGFR inhibitors: the clinical psychologist's perspective. Impact on health-related quality of life and implications for clinical management of psychological sequelae. Oncology (Williston Park). 2007; 21 (11 Suppl 5): 34-6. PubMed PMID: 18154217. |
| [10] | Eilers RE, Jr., Gandhi M, Patel JD, Mulcahy MF, Agulnik M, Hensing T, et al. Dermatologic infections in cancer patients treated with epidermal growth factor receptor inhibitor therapy. J Natl Cancer Inst. 2010; 102 (1): 47-53. doi: 10.1093/jnci/djp439. PubMed PMID: 20007525. |
| [11] | Lacouture ME, Mitchell EP, Piperdi B, Pillai MV, Shearer H, Iannotti N, 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. doi: 10.1200/JCO.2008.21.7828. PubMed PMID: 20142600. |
| [12] | Kobayashi Y, Komatsu Y, Yuki S, Fukushima H, Sasaki T, Iwanaga I, et al. Randomized controlled trial on the skin toxicity of panitumumab in Japanese patients with metastatic colorectal cancer: HGCSG1001 study; J-STEPP. Future Oncol. 2015; 11 (4): 617-27. doi: 10.2217/fon.14.251. PubMed PMID: 25686117. |
| [13] | Petrelli F, Borgonovo K, Cabiddu M, Coinu A, Ghilardi M, Lonati V, et al. Antibiotic prophylaxis for skin toxicity induced by antiepidermal growth factor receptor agents: a systematic review and meta-analysis. Br J Dermatol. 2016; 175 (6): 1166-74. doi: 10.1111/bjd.14756. PubMed PMID: 27214209. |
| [14] | De Tursi M, Zilli M, Carella C, Auriemma M, Lisco MN, Di Nicola M, et al. Skin toxicity evaluation in patients treated with cetuximab for metastatic colorectal cancer: a new tool for more accurate comprehension of quality of life impacts. Onco Targets Ther. 2017; 10: 3007-15. doi: 10.2147/OTT.S127795. PubMed PMID: 28670133; PubMed Central PMCID: PMCPMC5481280. |
| [15] | Joshi SS, Ortiz S, Witherspoon JN, Rademaker A, West DP, Anderson R, et al. Effects of epidermal growth factor receptor inhibitor-induced dermatologic toxicities on quality of life. Cancer. 2010; 116 (16): 3916-23. doi: 10.1002/cncr.25090. PubMed PMID: 20564072. |
| [16] | Lacouture ME, Anadkat MJ, Bensadoun RJ, Bryce J, Chan A, Epstein JB, et al. Clinical practice guidelines for the prevention and treatment of EGFR inhibitor-associated dermatologic toxicities. Support Care Cancer. 2011; 19 (8): 1079-95. doi: 10.1007/s00520-011-1197-6. PubMed PMID: 21630130; PubMed Central PMCID: PMCPMC3128700. |
| [17] | Bensadoun RJ, Humbert P, Krutman J, Luger T, Triller R, Rougier A, et al. Daily baseline skin care in the prevention, treatment, and supportive care of skin toxicity in oncology patients: recommendations from a multinational expert panel. Cancer Manag Res. 2013; 5: 401-8. doi: 10.2147/CMAR.S52256. PubMed PMID: 24353440; PubMed Central PMCID: PMCPMC3862511. |
| [18] | Hassel JC, Kripp M, Al-Batran S, Hofheinz RD. Treatment of epidermal growth factor receptor antagonist-induced skin rash: results of a survey among German oncologists. Onkologie. 2010; 33 (3): 94-8. doi: 10.1159/000277656. PubMed PMID: 20215799. |
| [19] | Peuvrel L, Bachmeyer C, Reguiai Z, Bachet JB, Andre T, Bensadoun RJ, et al. Survey on the management of skin toxicity associated with EGFR inhibitors amongst French physicians. J Eur Acad Dermatol Venereol. 2013; 27 (4): 419-29. doi: 10.1111/j.1468-3083.2011.04421.x. PubMed PMID: 22211860. |
