Management of cutaneous side-effects of cetuximab therapy

Hyo-Jung Lee°, Jae-Yeon Kim, Young-Cheon Song

Department of Pharmacy, Asan Medical Center

Backgroud
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 (EGFRI) often cause skin toxicity, most frequently acneiform eruption. Xerosis, eczema, fissures, nail changes and paronychia can be seen in some cases but, an effective treatment regimen is needed.

Materials and methods
We reviewed cutaneous adverse reactions of cetuximab in 20 patients with colorectal cancer who referred to dermatology at Asan Medical Center from January 2010 to August 2011. Skin toxicity was evaluated according to NCI CTCAE, v3.0.

Results
The most common adverse reaction was acneiform eruptions. This reaction appeared within 2 months after medication. Pruritus was the second most common reaction, which was mild and generalized, especially around eyelid area. After the first referred dermatology, treatment by a dermatologist was started. The lesions partially improved after treatment with topical emollients and systemic and topical antibiotics.

Conclusion
During the treatment with EGFRI, it is necessary to recognize and manage adverse reactions promptly to assure better patient quality of life and allowing continuation of therapy. The skin complications could be alleviated with dermatologic consultations and treatments, skin complications could be alleviated.

주제어 : cetuximab, cutaneous side-effects, dermatology