Review article

Cutaneous side effects of targeted therapy for colorectal carcinoma

Daniela Ledić Drvar
Antonio Juretić
Daška Štulhofer-Buzina
Ivana Manola

Abstract

Research in cancer development has led to the new treatment strategies based on gene and protein changes in cells that cause cancer. Such targeted drugs work differently than standard chemotherapy agents, and have different and usually less severe side effects. Targeted chemotherapies have, however, enormous cutaneous adverse events which may lead to poor adherence, dose interruption and discontinuation of these therapeutic regimens. Skin changes have a significant influence on the quality of life of affected patients. In colorectal cancer, several targeted drugs are currently employed. Agents administered in colorectal cancer that have resulted in significant cutaneous side effects include primarily the epidermal growth factor receptor inhibitors (EGFRIs) and capecitabine. Common EGFRIs dermatologic adverse events are acneiform rash and xerosis. Less common findings are paronychia, regulatory abnormalities of hair growth, maculopapular rash, mucositis and postinflammatory hyperpigmentation. Management of skin rash should be individualized for each patient, depending on the type, severity and location of the skin toxicity caused by EGFRIs. Hand-foot syndrome (HFS), or palmar-plantar erythrodysestesia, is the most common dose-limiting toxicity and the only clinically significant adverse event that frequently occurs with capecitabine compared to 5-FU/leucovorin intravenous administration. Cutaneous side effects affect compliance, patients’ quality of life, as well as the therapy regimen. It is important to recognize and treat, as well as to administer efficacious prophylactic and therapeutic measures in a timely manner. This enables regular administration of adequate chemotherapy regimens and prolongs lives of oncology patients. Studies have demonstrated a positive correlation between treatment efficacy and cutaneous side effects for both EGFRI and capecitabine. Therefore, cutaneous side effects can serve as a predictor of improved survival in these patients. Since frequency and severity of skin lesions are dose-dependent, a gradual increase in dose until a cutaneous side-effect develops might be a good strategy to maximize the efficacy of EGFRIs and capecitabine.

Keywords

targeted therapy; cutaneous side effects; colorectal cancer

Hrčak ID:

139049

URI

https://hrcak.srce.hr/139049

Publication date:

14.5.2015.

Article data in other languages: croatian

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