Chanprapaph Kumutnart, Pongcharoen Padcha, Vachiramon Vasanop
Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Indian J Dermatol Venereol Leprol. 2015 Sep-Oct;81(5):547. doi: 10.4103/0378-6323.157448.
Previous reports regarding the cutaneous adverse events of epidermal growth factor receptor inhibitors are mostly limited to small case reports and case series, mainly involving Caucasian patients.
We describe the trends in the clinical presentation of Asian patients who had cutaneous adverse events induced by epidermal growth factor receptor inhibitors and to explore the relationship between skin adverse events and tumor response.
From 2006 to 2010, medical records of Thai patients with non-small cell lung cancer receiving epidermal growth factor receptor inhibitors were retrieved and analyzed.
In all, 99 patients were reviewed and analyzed. Erlotinib and gefitinib were commenced in 75 (75.8%) and 24 (24.2%) patients, respectively. Cutaneous adverse events occurred in 43 (57.3%) patients receiving erlotinib and in 15 (62.5%) patients receiving gefitinib. The most common adverse event was xerosis (52.5%). Less common adverse events included papulo-pustular eruption (27.3%), erythematous maculopapular rash (11.1%), mucositis (6.7%), paronychia (5.1%), and trichomegaly (2%). Elderly patients had a higher occurrence of xerosis. The presence of cutaneous adverse events was significantly higher in subjects who had a tumor response.
The limitations of study include its retrospective nature, and the initial screening of cutaneous adverse events was done by non-dermatologists.
Cutaneous adverse events due to epidermal growth factor receptor inhibitors are not uncommon in the Asian population. We found a positive correlation between the occurrences of cutaneou adverse events and tumor response supporting the view that they are surrogate markers for therapeutic response.
先前关于表皮生长因子受体抑制剂皮肤不良事件的报告大多局限于小型病例报告和病例系列,主要涉及白种人患者。
我们描述了亚洲患者因表皮生长因子受体抑制剂引起皮肤不良事件的临床表现趋势,并探讨皮肤不良事件与肿瘤反应之间的关系。
检索并分析2006年至2010年泰国非小细胞肺癌患者接受表皮生长因子受体抑制剂治疗的医疗记录。
共对99例患者进行了回顾性分析。分别有75例(75.8%)和24例(24.2%)患者开始使用厄洛替尼和吉非替尼。接受厄洛替尼治疗的患者中有43例(57.3%)发生皮肤不良事件,接受吉非替尼治疗的患者中有15例(62.5%)发生皮肤不良事件。最常见的不良事件是皮肤干燥(52.5%)。较少见的不良事件包括丘疹脓疱性皮疹(27.3%)、红斑性斑丘疹(11.1%)、口腔炎(6.7%)、甲沟炎(5.1%)和睫毛粗长(2%)。老年患者皮肤干燥的发生率较高。有肿瘤反应的患者皮肤不良事件的发生率明显更高。
本研究的局限性包括其回顾性特点,且皮肤不良事件的初始筛查由非皮肤科医生进行。
在亚洲人群中,表皮生长因子受体抑制剂引起的皮肤不良事件并不少见。我们发现皮肤不良事件的发生与肿瘤反应之间存在正相关,支持了它们是治疗反应替代标志物的观点。