NCCN Task Force Report: Management of Dermatologic and Other Toxicities Associated With EGFR Inhibition in Patients With Cancer

This NCCN Task Force Report describes the management of dermatologic and ocular toxicities that occur in patients treated with epidermal growth factor receptor (EGFR) inhibitors. Task force members are from NCCN member institutions and include oncologists, dermatologists, an ophthalmologist, and a mid-level oncology provider. This report describes commonly used therapies that the task force agreed are appropriate standards of care for dermatologic and ophthalmologic toxicities associated with EGFR inhibitors, which generally are supported only by anecdotal evidence. Few recommendations are evidence based; however, some commonly used therapies have data supporting their use. Conclusions from completed clinical trials are generally limited by the small numbers of patients enrolled. The information in this report is based on available published data on treating toxicities associated with EGFR inhibitors, data from treatment of clinically similar toxicities from different etiologies, and expert opinion among the NCCN Task Force members.

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References

  • 1

    MendelsohnJ. Targeting the epidermal growth factor receptor for cancer therapy. J Clin Oncol2002;20:1s13s.

  • 2

    CastilloLEtienne-GrimaldiMCFischelJL. Pharmacological background of EGFR targeting. Ann Oncol2004;15:10071012.

  • 3

    WeberRSLustigRGlissonB. A phase II trial of ZD 1869 for advanced cutaneous squamous cell carcinoma of the head and neck [Abstract]. J Clin Oncol2007;25(Suppl 1):Abstract 6038.

    • Search Google Scholar
    • Export Citation
  • 4

    SaltzLRubinMHochsterH. Cetuximab (IMC-C225) plus irinotecan (CPT-11) is active in CPT-11-refractory colorectal cancer (CRC) that expresses epidermal growth factor receptor (EGFR) [Abstract]. Proc Am Soc Clin Oncol2001;20:Abstract 7.

    • Search Google Scholar
    • Export Citation
  • 5

    CunninghamDHumbletYSienaS. Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Engl J Med2004;351:337345.

    • Search Google Scholar
    • Export Citation
  • 6

    SaltzLBMeropolNJLoehrerPJSr. Phase II trial of cetuximab in patients with refractory colorectal cancer that expresses the epidermal growth factor receptor. J Clin Oncol2004;22:12011208.

    • Search Google Scholar
    • Export Citation
  • 7

    Van CutsemELangID’haensG. KRAS status and efficacy in the first-line treatment of patients with metastatic colorectal cancer (mCRC) treated with FOLFIRI with or without cetuximab: the CRYSTAL experience [Abstract]. J Clin Oncol2008;26(Suppl 1):Abstract 2.

    • Search Google Scholar
    • Export Citation
  • 8

    PirkerRSzczesnaAvon PawelJ. FLEX: a randomized, multicenter, phase III study of cetuximab in combination with cisplatin/vinorelbine (CV) versus CV alone in the first-line treatment of patients with advanced non-small cell lung cancer (NSCLC) [Abstract]. J Clin Oncol2008;26(Suppl 1):Abstract 3.

    • Search Google Scholar
    • Export Citation
  • 9

    BonnerJAHarariPMGiraltJ. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med2006;354:567578.

  • 10

    VermorkenJBMesiaRRiveraF. Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med2008;359:11161127.

  • 11

    Van CutsemEPeetersMSienaS. Open-label phase III trial of panitumumab plus best supportive care compared with best supportive care alone in patients with chemotherapy-refractory metastatic colorectal cancer. J Clin Oncol2007;25:16581664.

    • Search Google Scholar
    • Export Citation
  • 12

    AmadoRGWolfMPeetersM. Wild-type KRAS is required for panitumumab efficacy in patients with metastatic colorectal cancer. J Clin Oncol2008;26:16261634.

    • Search Google Scholar
    • Export Citation
  • 13

    BokemeyerCBondarenkoIHartmannJT. KRAS status and efficacy of first-line treatment of patients with metastatic colorectal cancer (mCRC) with FOLFOX with or without cetuximab: the OPUS experience [Abstract]. J Clin Oncol2008;26(Suppl 1): Abstract 4000.

    • Search Google Scholar
    • Export Citation
  • 14

    RielyGJPaoWPhamD. Clinical course of patients with non-small cell lung cancer and epidermal growth factor receptor exon 19 and exon 21 mutations treated with gefitinib or erlotinib. Clin Cancer Res2006;12(3 Pt 1):839844.

    • Search Google Scholar
    • Export Citation
  • 15

    MooreMJGoldsteinDHammJ. Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials group. J Clin Oncol2007;25:19601966.

    • Search Google Scholar
    • Export Citation
  • 16

    DudekAZKmakKLKoopmeinersJKeshtgarpourM. Skin rash and bronchoalveolar histology correlates with clinical benefit in patients treated with gefitinib as a therapy for previously treated advanced or metastatic non-small cell lung cancer. Lung Cancer2006;51:8996.

    • Search Google Scholar
    • Export Citation
  • 17

    ChangAParikhPThongprasertS. Gefitinib (IRESSA) in patients of Asian origin with refractory advanced non-small cell lung cancer: subset analysis from the ISEL study. J Thorac Oncol2006;1:847855.

    • Search Google Scholar
    • Export Citation
  • 18

    RyanQIbrahimACohenMH. FDA drug approval summary: lapatinib in combination with capecitabine for previously treated metastatic breast cancer that overexpresses HER-2. Oncologist2008;13:11141119.

    • Search Google Scholar
    • Export Citation
  • 19

    CameronDCaseyMPressM. A phase III randomized comparison of lapatinib plus capecitabine versus capecitabine alone in women with advanced breast cancer that has progressed on trastuzumab: updated efficacy and biomarker analyses. Breast Cancer Res Treat2008;112:533543.

    • Search Google Scholar
    • Export Citation
  • 20

    GeyerCEForsterJLindquistD. Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med2006;355:27332743.

  • 21

    MyskowskiPLHalpernAC. Cutaneous adverse reactions to therapeutic monoclonal antibodies for cancer. Curr Allergy Asthma Rep2008;8:6368.

    • Search Google Scholar
    • Export Citation
  • 22

    SaltzLKiesMAbbruzzeseJL. The presence and intensity of the cetuximab-induced acne-like rash predicts increased survival in studies across multiple malignancies [Abstract]. Proc Am Soc Clin Oncol2003;22:Abstract 817.

    • Search Google Scholar
    • Export Citation
  • 23

    WackerBNagraniTWeinbergJ. Correlation between development of rash and efficacy in patients treated with the epidermal growth factor receptor tyrosine kinase inhibitor erlotinib in two large phase III studies. Clin Cancer Res2007;13:39133921.

    • Search Google Scholar
    • Export Citation
  • 24

    HechtJRPatnaikABerlinJ. Panitumumab monotherapy in patients with previously treated metastatic colorectal cancer. Cancer2007;110:980988.

    • Search Google Scholar
    • Export Citation
  • 25

    Van CutsemENowackiMLangI. Randomized phase III study of irinotecan and 5-FU/FA with or without cetuximab in the first-line treatment of patients with metastatic colorectal cancer (mCRC): the CRYSTAL trial [Abstract]. J Clin Oncol2007;25(Suppl 1):Abstract 4000.

    • Search Google Scholar
    • Export Citation
  • 26

    BonnerJAHarariPMGiraltJ. The relationship of cetauximab-induced rash and survival in patients with head and neck cancer treated with radiotherapy and cetuximab [Abstract]. Int J Radiat Oncol Biol Phys2005;63:S73.

    • Search Google Scholar
    • Export Citation
  • 27

    BooneSLRademakerALiuD. Impact and management of skin toxicity associated with anti-epidermal growth factor receptor therapy: survey results. Oncology2007;72:152159.

    • Search Google Scholar
    • Export Citation
  • 28

    WagnerLILacoutureME. Dermatologic toxicities associated with EGFR inhibitors: the clinical psychologist’s perspective. Impact on health-related quality of life and implications for clinical management of psychological sequelae. Oncology (Williston Park)2007;21(11 Suppl 5):3436.

    • Search Google Scholar
    • Export Citation
  • 29

    LacoutureMELaiSE. The PRIDE (papulopustules and/or paronychia, regulatory abnormalities of hair growth, itching, and dryness due to epidermal growth factor receptor inhibitors) syndrome. Br J Dermatol2006;155:852854.

    • Search Google Scholar
    • Export Citation
  • 30

    AgeroALDuszaSWBenvenuto-AndradeC. Dermatologic side effects associated with the epidermal growth factor receptor inhibitors. J Am Acad Dermatol2006;55:657670.

    • Search Google Scholar
    • Export Citation
  • 31

    National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE)version 3.0. Available from: (http://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/ctcaev3.pdf). Accessed March 16 2009.

    • Search Google Scholar
    • Export Citation
  • 32

    HerbstRSMaddoxAMRothenbergML. Selective oral epidermal growth factor receptor tyrosine kinase inhibitor ZD1839 is generally well-tolerated and has activity in non–small-cell lung cancer and other solid tumors: results of a phase I trial. J Clin Oncol2002;20:38153825.

    • Search Google Scholar
    • Export Citation
  • 33

    WitherspoonJNWagnerLRademakerA. Correlation of patient characteristics and NCI-Common Terminology Criteria for Adverse Events (CTCAE) v 3.0 grading with dermatology-related quality of life (QoL) in patients with EGFR inhibitor-induced rash [Abstract]. J Clin Oncol2008;26(Suppl 1):Abstract 9559.

    • Search Google Scholar
    • Export Citation
  • 34

    Van CutsemE. Challenges in the use of epidermal growth factor receptor inhibitors in colorectal cancer. Oncologist2006;11:10101017.

  • 35

    SegaertSVan CutsemE. Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors. Ann Oncol2005;16:14251433.

    • Search Google Scholar
    • Export Citation
  • 36

    BusamKJCapodieciPMotzerR. Cutaneous side-effects in cancer patients treated with the antiepidermal growth factor receptor antibody C225. Br J Dermatol2001;144:11691176.

    • Search Google Scholar
    • Export Citation
  • 37

    YanoSKondoKYamaguchiM. Distribution and function of EGFR in human tissue and the effect of EGFR tyrosine kinase inhibition. Anticancer Res2003;23:36393650.

    • Search Google Scholar
    • Export Citation
  • 38

    PiepkornMPreddHUnderwoodRCookP. Proliferation-differentiation relationships in the expression of heparin-binding epidermal growth factor-related factors and erbB receptors by normal and psoriatic human keratinocytes. Arch Dermatol Res2003;295:93101.

    • Search Google Scholar
    • Export Citation
  • 39

    LacoutureME. Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer2006;6:803812.

  • 40

    AlbanellJRojoFAverbuchS. Pharmacodynamic studies of the epidermal growth factor receptor inhibitor ZD1839 in skin from cancer patients: histopathologic and molecular consequences of receptor inhibition. J Clin Oncol2002;20:110124.

    • Search Google Scholar
    • Export Citation
  • 41

    BaselgaJRischinDRansonM. Phase I safety, pharmacokinetic, and pharmacodynamic trial of ZD1839, a selective oral epidermal growth factor receptor tyrosine kinase inhibitor, in patients with five selected solid tumor types. J Clin Oncol2002;20:42924302.

    • Search Google Scholar
    • Export Citation
  • 42

    ShepherdFARodrigues PereiraJCiuleanuT. Erlotinib in previously treated non–small-cell lung cancer. N Engl J Med2005;353:123132.

  • 43

    LacoutureMELaabsSMKoehlerM. Analysis of dermatologic events in patients with cancer treated with lapatinib. Breast Cancer Res Treat2009;114:485493.

    • Search Google Scholar
    • Export Citation
  • 44

    MossJEBurtnessB. Cetuximab-associated acneiform eruption. N Engl J Med2005;353:e17.

  • 45

    LauxIJainASinghSAgusDB. Epidermal growth factor receptor dimerization status determines skin toxicity to HER-kinase targeted therapies. Br J Cancer2006;94:8592.

    • Search Google Scholar
    • Export Citation
  • 46

    El-AbaseriTBPuttaSHansenLA. Ultraviolet irradiation induces keratinocyte proliferation and epidermal hyperplasia through the activation of the epidermal growth factor receptor. Carcinogenesis2006;27:225231.

    • Search Google Scholar
    • Export Citation
  • 47

    LuuMLaiSEPatelJ. Photosensitive rash due to the epidermal growth factor receptor inhibitor erlotinib. Photodermatol Photoimmunol Photomed2007;23:4245.

    • Search Google Scholar
    • Export Citation
  • 48

    LaiSEMinnellyLO’KeeffeP. Influence of skin color in the development of erlotinib-induced rash: a report from the SERIES clinic [Abstract]. J Clin Oncol2007;25(Suppl 1):Abstract 9127.

    • Search Google Scholar
    • Export Citation
  • 49

    GridelliCMaionePAmorosoD. Clinical significance and treatment of skin rash from erlotinib in non-small cell lung cancer patients: results of an Experts Panel Meeting. Crit Rev Oncol Hematol2008;66:155162.

    • Search Google Scholar
    • Export Citation
  • 50

    EdgerlyMFojoT. Is there room for improvement in adverse event reporting in the era of targeted therapies?J Natl Cancer Inst2008;100:240242.

    • Search Google Scholar
    • Export Citation
  • 51

    Pérez-SolerRDelordJPHalpernA. HER1/EGFR inhibitor-associated rash: future directions for management and investigation outcomes from the HER1/EGFR inhibitor rash management forum. Oncologist2005;10:345356.

    • Search Google Scholar
    • Export Citation
  • 52

    FoxLP. Nail toxicity associated with epidermal growth factor receptor inhibitor therapy. J Am Acad Dermatol2007;56:460465.

  • 53

    LordHKJunorEIronsideJ. Cetuximab is effective, but more toxic than reported in the Bonner trial. Clin Oncol (R Coll Radiol)2008;20:96.

  • 54

    EilersREWestDPOrtizS. Dermatologic infections complicate epidermal growth factor receptor inhibitor (EGFRI) therapy in cancer patients. J Am Acad Dermatol2009;60(Suppl 3):AB3. Abstract P201.

    • Search Google Scholar
    • Export Citation
  • 55

    PryorDIPorcedduSVBurmeisterBH. Enhanced toxicity with concurrent cetuximab and radiotherapy in head and neck cancer. Radiother Oncol2009;90:172176.

    • Search Google Scholar
    • Export Citation
  • 56

    Vano-GalvanSde las HerasEHartoAJaenP. Severe cutaneous toxicity during concomitant radiotherapy and cetuximab treatment of head and neck cancer. Eur J Dermatol2008;18:471472.

    • Search Google Scholar
    • Export Citation
  • 57

    GiroCBergerBBölkeE. High rate of severe radiation dermatitis during radiation therapy with concurrent cetuximab in head and neck cancer: results of a survey in EORTC institutes. Radiother Oncol2009;90:166171.

    • Search Google Scholar
    • Export Citation
  • 58

    MitraSSSimcockR. Erlotinib induced skin rash spares skin in previous radiotherapy field. J Clin Oncol2006;24:e2829.

  • 59

    AcharyaJLyonCBottomleyDM. Folliculitis-perifolliculitis related to erlotinib therapy spares previously irradiated skin. J Am Acad Dermatol2009;60:154157.

    • Search Google Scholar
    • Export Citation
  • 60

    GerberPAEnderleinEHomeyB. Radiation-induced prevention of erlotinib-induced skin rash is transient: a new aspect toward the understanding of epidermal growth factor receptor inhibitor associated cutaneous adverse effects. J Clin Oncol2007;25:46974698; author reply 4698–4699.

    • Search Google Scholar
    • Export Citation
  • 61

    LacoutureMEHwangCMarymontMHPatelJ. Temporal dependence of the effect of radiation on erlotinib-induced skin rash. J Clin Oncol2007;25:2140; author reply 2141.

    • Search Google Scholar
    • Export Citation
  • 62

    TejwaniAWuSJiaY. Increased risk of high-grade dermatologic toxicities with radiation plus epidermal growth factor receptor inhibitor therapy. Cancer2009;115:12861299.

    • Search Google Scholar
    • Export Citation
  • 63

    BudachWBölkeEHomeyB. Severe cutaneous reaction during radiation therapy with concurrent cetuximab. N Engl J Med2007;357:514515.

  • 64

    BölkeEGerberPALammeringG. Development and management of severe cutaneous side effects in head-and-neck cancer patients during concurrent radiotherapy and cetuximab. Strahlenther Onkol2008;184:105110.

    • Search Google Scholar
    • Export Citation
  • 65

    BonnerJAAngKBudachW. More on severe cutaneous reaction with radiotherapy and cetuximab. N Engl J Med2007;357:18721873.

  • 66

    TanARYangXHewittSM. Evaluation of biologic end points and pharmacokinetics in patients with metastatic breast cancer after treatment with erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor. J Clin Oncol2004;22:30803090.

    • Search Google Scholar
    • Export Citation
  • 67

    RoéEMuretMMarcuelloE. Description and management of cutaneous side effects during cetuximab or erlotinib treatments: a prospective study of 30 patients. J Am Acad Derm2006;55:429437.

    • Search Google Scholar
    • Export Citation
  • 68

    KonheimABrebachESamuelJ. Magnetic resonance imaging of paronychia induced by cetuximab. Clin Exp Dermatol2009; in press.

  • 69

    BowlerPGDuerdenBIArmstrongDG. Wound microbiology and associated approaches to wound management. Clin Microbiol Rev2001;14:244269.

  • 70

    EdwardsRHardingKG. Bacteria and wound healing. Curr Opin Infect Dis2004;17:9196.

  • 71

    WysockiAB. Evaluating and managing open skin wounds: colonization versus infection. AACN Clin Issues2002;13:382397.

  • 72

    CostaDBKobayashiSSchumerST. Erlotinib-associated alopecia in a lung cancer patient. J Thorac Oncol2007;2:11361138.

  • 73

    DonovanJCGhazarianDMShawJC. Scarring alopecia associated with use of the epidermal growth factor receptor inhibitor gefitinib. Arch Dermatol2008;144:15241525.

    • Search Google Scholar
    • Export Citation
  • 74

    GravesJEJonesBFLindACHeffernanMP. Nonscarring inflammatory alopecia associated with the epidermal growth factor receptor inhibitor gefitinib. J Am Acad Dermatol2006;55:349353.

    • Search Google Scholar
    • Export Citation
  • 75

    CarserJESummersYJ. Trichomegaly of the eyelashes after treatment with erlotinib in non-small cell lung cancer. J Thorac Oncol2006;1:10401041.

    • Search Google Scholar
    • Export Citation
  • 76

    BraitehFKurzrockRJohnsonFM. Trichomegaly of the eyelashes after lung cancer treatment with the epidermal growth factor receptor inhibitor erlotinib. J Clin Oncol2008;26:34603462.

    • Search Google Scholar
    • Export Citation
  • 77

    LaneKGoldsteinSM. Erlotinib-associated trichomegaly. Ophthal Plast Reconstr Surg2007;23:6566.

  • 78

    LiuZCarvajalMCarrawayCA. Expression of the receptor tyrosine kinases, epidermal growth factor receptor, ErbB2 and ErbB3 in human ocular surface epithelia. Cornea2001;20:8185.

    • Search Google Scholar
    • Export Citation
  • 79

    BastiS. Ocular toxicities of epidermal growth factor receptor inhibitors and their management. Cancer Nurs2007;30(4 Suppl 1):S1016.

  • 80

    FoersterCGCursiefenCKruseFE. Persisting corneal erosion under cetuximab (Erbitux) treatment (epidermal growth factor receptor antibody). Cornea2008;27:612614.

    • Search Google Scholar
    • Export Citation
  • 81

    MethvinABGausasRE. Newly recognized ocular side effects of erlotinib. Ophthal Plast Reconstr Surg2007;23:6365.

  • 82

    ZhangGBastiSJampolLM. Acquired trichomegaly and symptomatic external ocular changes in patients receiving epidermal growth factor receptor inhibitors: case reports and a review of literature. Cornea2007;26:858860.

    • Search Google Scholar
    • Export Citation
  • 83

    ShahNTKrisMGPaoW. Practical management of patients with non–small-cell lung cancer treated with gefitinib. J Clin Oncol2005;23:165174.

    • Search Google Scholar
    • Export Citation
  • 84

    FukuokaMYanoSGiacconeG. Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non–small-cell lung cancer. J Clin Oncol2003;21:22372246.

    • Search Google Scholar
    • Export Citation
  • 85

    SegaertSVan CutsemE. Clinical management of EGFRI dermatologic toxicities: the European perspective. Oncology (Williston Park)2007;21(11 Suppl 5):2226.

    • Search Google Scholar
    • Export Citation
  • 86

    LacoutureMECotliarJMitchellEP. Clinical management of EGFRI dermatologic toxicities: US perspective. Oncology (Williston Park)2007;21(11 Suppl 5):1721.

    • Search Google Scholar
    • Export Citation
  • 87

    YamazakiNMuroK. Clinical management of EGFRI dermatologic toxicities: the Japanese perspective. Oncology (Williston Park)2007;21(11 Suppl 5):2728.

    • Search Google Scholar
    • Export Citation
  • 88

    ScopeAAgeroALDuszaSW. Randomized double-blind trial of prophylactic oral minocycline and topical tazarotene for cetuximab-associated acne-like eruption. J Clin Oncol2007;25:53905396.

    • Search Google Scholar
    • Export Citation
  • 89

    FoxLP. Pathology and management of dermatologic toxicities associated with anti-EGFR therapy. Oncology (Williston Park)2006;20(Suppl 2):2634.

    • Search Google Scholar
    • Export Citation
  • 90

    ScopeALiebJADuszaSW. A prospective randomized trial of topical pimecrolimus for cetuximab-associated acne-like eruption. J Am Acad Dermatol2009; in press.

    • Search Google Scholar
    • Export Citation
  • 91

    LynchTJJrKimESEabyB. Epidermal growth factor receptor inhibitor-associated cutaneous toxicities: an evolving paradigm in clinical management. Oncologist2007;12:610621.

    • Search Google Scholar
    • Export Citation
  • 92

    HuJCSadeghiPPinter-BrownLC. Cutaneous side effects of epidermal growth factor receptor inhibitors: clinical presentation, pathogenesis, and management. J Am Acad Dermatol2007;56:317326.

    • Search Google Scholar
    • Export Citation
  • 93

    RaccaPFanchiniLCaliendoV. Efficacy and skin toxicity management with cetuximab in metastatic colorectal cancer: outcomes from an oncologic/dermatologic cooperation. Clin Colorectal Cancer2008;7:4854.

    • Search Google Scholar
    • Export Citation
  • 94

    VezzoliPMarzanoAVOnidaF. Cetuximab-induced acneiform eruption and the response to isotretinoin. Acta Derm Venereol2008;88:8486.

  • 95

    GutzmerRWerfelTMaoR. Successful treatment with oral isotretinoin of acneiform skin lesions associated with cetuximab therapy. Br J Dermatol2005;153:849851.

    • Search Google Scholar
    • Export Citation
  • 96

    PomerantzRGChirinosREFaloLDJrGeskinLJ. Acitretin for treatment of EGFR inhibitor-induced cutaneous toxic effects. Arch Dermatol2008;144:949950.

    • Search Google Scholar
    • Export Citation
  • 97

    Perez-SolerRZouYLiT. Topical vitamin K3 (Vit K3, Menadione) prevents erlotinib and cetuximab-induced EGFR inhibition in the skin [Abstract]. J Clin Oncol2006;24(Suppl 1):Abstract 3036.

    • Search Google Scholar
    • Export Citation
  • 98

    Perez-SolerRZouYLiTLingY. Steroids and immunosuppressive agents potentiate the cytotoxicity of the EGFR inhibitor erlotinib (E) in human skin keratinocytes whereas Vit K3 exerts a protective effect: implications for the management of the skin rash [Abstract]. J Clin Oncol2007;25(Suppl 1):Abstract 9124.

    • Search Google Scholar
    • Export Citation
  • 99

    BoströmALindmanHSwartlingC. Potent corticosteroid cream (mometasone furoate) significantly reduces acute radiation dermatitis: results from a double-blind, randomized study. Radiother Oncol2001;59:257265.

    • Search Google Scholar
    • Export Citation
  • 100

    BernierJBonnerJVermorkenJB. Consensus guidelines for the management of radiation dermatitis and coexisting acne-like rash in patients receiving radiotherapy plus EGFR inhibitors for the treatment of squamous cell carcinoma of the head and neck. Ann Oncol2008;19:142149.

    • Search Google Scholar
    • Export Citation
  • 101

    JatoiARowlandKSloanJA. Tetracycline to prevent epidermal growth factor receptor inhibitor-induced skin rashes: results of a placebo-controlled trial from the North Central Cancer Treatment Group (N03CB). Cancer2008;113:847853.

    • Search Google Scholar
    • Export Citation
  • 102

    LacoutureMEMitchellEPShearerH. Impact of pre-emptive skin toxicity (ST) treatment (tx) on panitumumab (pmab)-related skin toxicities and quality of life (QOL) in patients (pts) with metastatic colorectal cancer (mCRC): results from STEPP [Abstract]. ASCO Gastrointestinal Cancers Symposium2009;Abstract 291.

    • Search Google Scholar
    • Export Citation
  • 103

    SchmuthMWimmerMAHoferS. Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study. Br J Dermatol2002;146:983991.

    • Search Google Scholar
    • Export Citation
  • 104

    ElliottEAWrightJRSwannRS. Phase III trial of an emulsion containing trolamine for the prevention of radiation dermatitis in patients with advanced squamous cell carcinoma of the head and neck: results of Radiation Therapy Oncology Group trial 99-13. J Clin Oncol2006;24:20922097.

    • Search Google Scholar
    • Export Citation
  • 105

    PommierPGomezFSunyachMP. Phase III randomized trial of Calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer. J Clin Oncol2004;22:14471453.

    • Search Google Scholar
    • Export Citation
  • 106

    EabyBCulkinALacoutureME. An interdisciplinary consensus on managing skin reactions associated with human epidermal growth factor receptor inhibitors. Clin J Oncol Nurs2008;12:283290.

    • Search Google Scholar
    • Export Citation
  • 107

    OishiK. Clinical approaches to minimize rash associated with EGFR inhibitors. Oncol Nurs Forum2008;35:103111.

  • 108

    ShuhaiberJHLipnickSTeresiM. More on Monsel’s solution...Surgery2005;137:263264.

  • 109

    JetmoreABHeryerJWConnerWE. Monsel’s solution: a kinder, gentler hemostatic. Dis Colon Rectum1993;36:866867.

  • 110

    RuppMEMedcalfSJFeyPD. Monsel’s solution: a potential vector for nosocomial infection?Infect Control Hosp Epidemiol2003;24:142144.

  • 111

    PorzioGAielliFVernaL. Efficacy of pregabalin in the management of cetuximab-related itch. J Pain Symptom Manage2006;32:397398.

  • 112

    EhrchenJStänderS. Pregabalin in the treatment of chronic pruritus. J Am Acad Dermatol2008;58(2 Suppl):S3637.

  • 113

    ShuKYKindlerHLMedenicaMLacoutureM. Doxycycline for the treatment of paronychia induced by the epidermal growth factor receptor inhibitor cetuximab. Br J Dermatol2006;154:191192.

    • Search Google Scholar
    • Export Citation
  • 114

    TostiAPiracciniBMGhettiEColomboMD. Topical steroids versus systemic antifungals in the treatment of chronic paronychia: an open, randomized double-blind and double dummy study. J Am Acad Dermatol2002;47:7376.

    • Search Google Scholar
    • Export Citation
  • 115

    DonovanJCGhazarianDMShawJC. Scarring alopecia associated with use of the epidermal growth factor receptor inhibitor gefitinib. Arch Dermatol2008;144:15241525.

    • Search Google Scholar
    • Export Citation

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