Skin Toxicities Induced by Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors and their Influence on Treatment Adjustments in Lung Cancer Patients

Authors

  • Ji Su Lee Department of Dermatology, Seoul National University Hospital, Seoul, Korea; Laboratory of Cutaneous Aging and Hair Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea; Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University, Seoul, Korea
  • Jimin Woo Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
  • Tae Min Kim Department of Dermatology, Seoul National University Hospital, Seoul, Korea; Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
  • Namkyu Kim Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
  • Bhumsuk Keam Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
  • Seong Jin Jo Department of Dermatology, Seoul National University Hospital, Seoul, Korea; Laboratory of Cutaneous Aging and Hair Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea; Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University, Seoul, Korea; Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea

DOI:

https://doi.org/10.2340/actadv.v104.40555

Keywords:

Epidermal growth factor receptor tyrosine kinase inhibitors, Skin toxicities, Dermatological adverse events, Papulopusutlar rash, Xerosis, Paronychia, Pruritus

Abstract

Skin toxicities caused by epidermal growth factor receptor tyrosine kinase inhibitors can affect patient quality of life and lead to treatment adjustments, including dose reduction or discontinuation. This retrospective study aimed to profile skin toxicities and their impact on treatment adjustments. A total of 288 non-small cell lung cancer patients treated with first-, second-, or third-generation epidermal growth factor receptor tyrosine kinase inhibitors were included. Skin toxicities, including papulopustular rash, xerosis, paronychia, and pruritus, were assessed based on medical records, and their severity was evaluated based on the required dermatological intervention. Papulopustular rash was the most common toxicity (74.3%), followed by pruritus (61.1%), xerosis (52.4%), and paronychia (39.6%). Papulopustular rash was more common in males and more severe in younger patients. Papulopustular rash was more prevalent in patients treated with first- and second-generation epidermal growth factor receptor tyrosine kinase inhibitors, while paronychia was notably frequent for the second-generation epidermal growth factor receptor tyrosine kinase inhibitors. Second-generation epidermal growth factor receptor tyrosine kinase inhibitors frequently caused multiple skin toxicities. Importantly, skin toxicities led to epidermal growth factor receptor tyrosine kinase inhibitor treatment adjustments in 26.7% of cases, with second-generation epidermal growth factor receptor tyrosine kinase inhibitors demonstrating higher adjustment rates. Papulopustular rash and paronychia were the main causes of treatment adjustments, with even mild paronychia being linked to treatment adjustments. Effective management of skin toxicities is essential for optimizing treatment outcomes in patients receiving epidermal growth factor receptor tyrosine kinase inhibitors.

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Additional Files

Published

2024-08-28

How to Cite

Lee, J. S., Woo, J., Kim, T. M., Kim, N., Keam, B., & Jo, S. J. (2024). Skin Toxicities Induced by Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors and their Influence on Treatment Adjustments in Lung Cancer Patients. Acta Dermato-Venereologica, 104, adv40555. https://doi.org/10.2340/actadv.v104.40555