Author/Editor     Ocvirk, Janja; Reberšek, Martina
Title     Management of cutaneous side effectsof cetuximab therapy with vitamin K1 creme
Translated title     Obvladovanje neželenih učinkov na kožo s kremo z vitaminom K1 pri bolnikih zdravljenih s cetuksimabom
Type     članek
Source     Radiol Oncol
Vol. and No.     Letnik 42, št. 4
Publication year     2008
Volume     str. 215-24
Language     eng
Abstract     Background. Cetuximab is a chimeric human-murine monoclonal antibody against the epidermal growth factor receptor (EGFR). It has shown activities against multiple malignancies in clinical trials. EGFR-inhibitors often cause skin toxicity, most frequently acneiform eruption. Xerosis, eczema, fissures, teleangiectasias, nail changes and paronychia can be seen in some cases, rarely hyperpigmentation. The management of the skin toxicity helps patients to overcome cetuximab-associated skin toxicity and is of great importance for patients’ compliance. It is generally manageable with standard topical or systemic antibiotics and antiinflammatory agents. The education of patients prior to beginning the therapy and proactive intervention at the first signs of skin toxicity are keys to the successful management. The aim of our study was to investigate cutaneous side-effects of the treatment with cetuximab and to determine the efficacy of vitamin K1 creme. Methods. From September 2006 to August 2007 30 patients with metastatic colorectal cancer were treated with cetuximab in combination with chemotherapy and suffered from acne-like rash. They were followed at least 3 months, once per week. Skin care was taken with cream with urea and 0.1% K1 vitamin (Reconval K1®) topically starting after first documented cutaneous toxicity, and was evaluated according to NCI CTCAE, ver.3. Results. Of 30 patients 6 had grade 3 rash, 18 patients grade 2 and 6 patients grade 1. Reconval K1® was used twice daily. In all patients we observed the improvement of cutaneous toxicity. The median improvement was 8 days and 18 days to observe down-staging in rash at least for 1 grade. In only 3 of 6 patients with grade 3 toxicity the reduction of cetuximab dose was needed. In historical controls in all patients with grade 3 the reduction of cetuximab dose was recommended and performed. (Abstract truncated at 2000 characters)
Descriptors     ANTIBODIES, MONOCLONAL
EPIDERMAL GROWTH FACTOR RECEPTOR PROTEIN-TYROSINE KINASE
SKIN MANIFESTATIONS
COLORECTAL NEOPLASMS
PHYTONADIONE
NEOPLASM METASTASIS