Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Curr Opin Support Palliat Care. 2009 Dec;3(4):294-9. doi: 10.1097/SPC.0b013e328332d397.
To review the clinical presentation and management of cutaneous side effects of some of the new targeted anticancer therapies.
Advances in molecular biology have led to the development of pharmacologic agents that specifically target crucial molecules on malignant cells, or their surrounding cellular milieu (e.g. angiogenesis inhibitors), or both. Successful treatments for several solid tumors, including colorectal carcinoma, nonsmall cell lung cancer, head and neck cancer and renal cell carcinoma, have recently been implemented as a result of these advances. Although these agents are generally much better tolerated than their cytotoxic predecessors, new groups of side effects have emerged, especially with regard to the skin. Multikinase inhibitors, monoclonal antibodies, and - in particular - antiepidermal growth factor inhibitors are associated with cutaneous reactions that may not only be dose limiting, but may significantly affect quality of life. The spectrum of these reactions ranges from disfiguring acneiform facial eruptions, to impaired wound healing, to disabling hand-foot syndromes, which can seriously impair mobility.
The recognition, prevention and management of the cutaneous side effects of these targeted agents can allow successful continuation of antineoplastic therapy, and minimize patient distress.
回顾一些新型靶向抗癌治疗的皮肤副作用的临床表现和处理方法。
分子生物学的进步导致了针对恶性细胞上的关键分子或其周围细胞环境（例如血管生成抑制剂）或两者的药物的开发。由于这些进展，最近针对包括结直肠癌、非小细胞肺癌、头颈部癌和肾细胞癌在内的几种实体瘤实施了成功的治疗。尽管这些药物通常比细胞毒性药物的前代药物更耐受，但新的副作用群已经出现，尤其是皮肤。多激酶抑制剂、单克隆抗体，尤其是表皮生长因子抑制剂与皮肤反应相关，这些反应不仅可能具有剂量限制性，而且可能显著影响生活质量。这些反应的范围从毁容性痤疮样皮疹到伤口愈合受损，再到致残性手足综合征，严重影响活动能力。
识别、预防和管理这些靶向药物的皮肤副作用可以允许成功地继续进行抗肿瘤治疗，并最大程度地减少患者的痛苦。
