Skin Toxicities Induced by Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors and their Influence on Treatment Adjustments in Lung Cancer Patients

• Published in: Acta dermato-venereologica Vol. 104; p. adv40555
• Main Authors: Lee, Ji Su, Woo, Jimin, Kim, Tae Min, Kim, Namkyu, Keam, Bhumsuk, Jo, Seong Jin
• Format: Journal Article
• Language: English
• Published: Sweden MJS Publishing, on behalf of the Society for Publication of Acta Dermato-Venereologica 28.08.2024; Medical Journals Sweden
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Agents - adverse effects; Carcinoma, Non-Small-Cell Lung - drug therapy; Dermatological adverse events; Drug Eruptions - etiology; Epidermal growth factor receptor tyrosine kinase inhibitors; ErbB Receptors - antagonists & inhibitors; Female; Humans; Lung Neoplasms - drug therapy; Male; Middle Aged; Original Report; Papulopusutlar rash; Paronychia; Paronychia - chemically induced; Protein Kinase Inhibitors - adverse effects; Retrospective Studies; Risk Factors; Severity of Illness Index; Skin toxicities; Treatment Outcome; Tyrosine Kinase Inhibitors; Xerosis
• ISSN: 0001-5555; 1651-2057; 1651-2057
• DOI: 10.2340/actadv.v104.40555

Skin toxicities caused by epidermal growth factor receptor tyrosine kinase inhibitors can affect patient quality of life and lead to treatment adjustments, including dose reduction or discontinuation. This retrospective study aimed to profile skin toxicities and their impact on treatment adjustments. A total of 288 non-small cell lung cancer patients treated with first-, second-, or third-generation epidermal growth factor receptor tyrosine kinase inhibitors were included. Skin toxicities, including papulopustular rash, xerosis, paronychia, and pruritus, were assessed based on medical records, and their severity was evaluated based on the required dermatological intervention. Papulopustular rash was the most common toxicity (74.3%), followed by pruritus (61.1%), xerosis (52.4%), and paronychia (39.6%). Papulopustular rash was more common in males and more severe in younger patients. Papulopustular rash was more prevalent in patients treated with first- and second-generation epidermal growth factor receptor tyrosine kinase inhibitors, while paronychia was notably frequent for the second-generation epidermal growth factor receptor tyrosine kinase inhibitors. Second-generation epidermal growth factor receptor tyrosine kinase inhibitors frequently caused multiple skin toxicities. Importantly, skin toxicities led to epidermal growth factor receptor tyrosine kinase inhibitor treatment adjustments in 26.7% of cases, with second-generation epidermal growth factor receptor tyrosine kinase inhibitors demonstrating higher adjustment rates. Papulopustular rash and paronychia were the main causes of treatment adjustments, with even mild paronychia being linked to treatment adjustments. Effective management of skin toxicities is essential for optimizing treatment outcomes in patients receiving epidermal growth factor receptor tyrosine kinase inhibitors.