Cutaneous adverse effects of targeted therapies: Part I: Inhibitors of the cellular membrane

• Published in: Journal of the American Academy of Dermatology Vol. 72; no. 2; p. 203
• Main Authors: Macdonald, James B, Macdonald, Brooke, Golitz, Loren E, LoRusso, Patricia, Sekulic, Aleksandar
• Format: Journal Article
• Language: English
• Published: United States 01.02.2015
• Subjects: Alopecia - chemically induced; Angiogenesis Inhibitors - adverse effects; Antineoplastic Agents - adverse effects; Cell Membrane - drug effects; Dermatitis, Photoallergic - etiology; Dose-Response Relationship, Drug; Drug Eruptions - diagnosis; Drug Eruptions - etiology; Drug Eruptions - therapy; Fusion Proteins, bcr-abl - antagonists & inhibitors; Hair Diseases - chemically induced; Humans; Molecular Targeted Therapy - adverse effects; Mucositis - chemically induced; Nail Diseases - chemically induced; Receptor, Epidermal Growth Factor - antagonists & inhibitors; cancer treatment; small molecule; sorafenib; morbilliform; photosensitivity; lapatinib; panitumumab; xerosis; chemotherapy; mucocutaneous hemorrhage; canertinib; bevacizumab; side effects; drug reaction; sunitinib; papulopustular eruption; cetuximab; imatinib; gefitinib; drug rash; alopecia; KIT; dry skin; disturbed wound healing; pigment changes; paronychia; stomatitis; dual kinase inhibitors; erbB receptor; cutaneous adverse effects; hyperkeratotic hand–foot skin reaction; anticancer; ranibizumab; epidermal growth factor receptor inhibitors; tyrosine kinase inhibitors; antiangiogenic agents; dermatologic toxicities; drug eruption; multikinase inhibitors; dasatinib; nilotinib; platelet-derived growth factor receptor; adverse sequelae; supportive oncodermatology; targeted therapy; genital rash; macular eruption; toxic erythema; erlotinib; BCR-ABL; pazopanib; mucositis; vandetanib; vascular endothelial growth factor; HER2; monoclonal antibodies
• ISSN: 1097-6787
• DOI: 10.1016/j.jaad.2014.07.032

There has been a rapid emergence of numerous targeted agents in the oncology community in the last decade. This exciting paradigm shift in drug development lends promise for the future of individualized medicine. Given the pace of development and clinical deployment of targeted agents with novel mechanisms of action, dermatology providers may not be familiar with the full spectrum of associated skin-related toxicities. Cutaneous adverse effects are among the most frequently observed toxicities with many targeted agents, and their intensity can be dose-limiting or lead to therapy discontinuation. In light of the often life-saving nature of emerging oncotherapeutics, it is critical that dermatologists both understand the mechanisms and recognize clinical signs and symptoms of such toxicities in order to provide effective clinical management. Part I of this continuing medical education article will review in detail the potential skin-related adverse sequelae, the frequency of occurrence, and the implications associated with on- and off-target cutaneous toxicities of inhibitors acting at the cell membrane level, chiefly inhibitors of epidermal growth factor receptor, KIT, and BCR-ABL, angiogenesis, and multikinase inhibitors.