Okamoto Ken, Maeda Hiromichi, Shiga Takeo, Shiga Mai, Dabanaka Ken, Hanazaki Kazuhiro, Kobayashi Michiya
Ken Okamoto, Michiya Kobayashi, Department of Human Health and Medical Sciences, Kochi Medical School Hospital, Kochi 783-8505, Japan.
World J Gastroenterol. 2015 Mar 28;21(12):3746-9. doi: 10.3748/wjg.v21.i12.3746.
Monoclonal antibodies against epidermal growth factor receptor (EGFR) are used in the treatment of advanced colorectal cancer. However, these agents can induce severe dermatological side effects that discourage their administration in patients with chronic dermatological disease. EGFR plays a key role in normal skin development and immunological function, and is expressed in various tissues and organs, although contrarily, it is overexpressed in psoriasis-related skin lesions. Thus, discussion is ongoing regarding the putative pathological role and therapeutic potential of this protein. We herein report on a patient with advanced colon cancer and concomitant long-standing psoriasis vulgaris who received anti-EGFR antibody monotherapy as a third-line treatment for metastatic disease. One week after the initiation of treatment, the patient's skin lesions dramatically subsided and the improvement was sustained during therapy. Based on this case, we propose that anti-EGFR antibody therapy is not necessarily contraindicated in patients with psoriasis vulgaris. Moreover, the findings reaffirmed that EGFR is an important molecule in the pathology of psoriasis.
抗表皮生长因子受体(EGFR)单克隆抗体被用于治疗晚期结直肠癌。然而,这些药物会引发严重的皮肤副作用,这使得它们在患有慢性皮肤病的患者中难以应用。EGFR在正常皮肤发育和免疫功能中起关键作用,在各种组织和器官中均有表达,尽管相反的是,它在银屑病相关皮肤病变中过度表达。因此,关于这种蛋白质假定的病理作用和治疗潜力的讨论仍在进行。我们在此报告一名患有晚期结肠癌并伴有长期寻常型银屑病的患者,该患者接受了抗EGFR抗体单药治疗作为转移性疾病的三线治疗。治疗开始一周后,患者的皮肤病变显著消退,且在治疗期间持续改善。基于此病例,我们提出抗EGFR抗体治疗不一定对寻常型银屑病患者禁忌。此外,这些发现再次证实EGFR是银屑病病理学中的一个重要分子。