Information for Healthcare Professionals

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This website has been developed as a comprehensive resource providing information on the management of multikinase inhibitor-associated skin toxicities.

Multikinase inhibitors (MKIs) are small molecule inhibitors of multiple, membrane-bound and intracellular kinases involved in various normal cellular functions and pathologic processes including, oncogenesis, tumour angiogenesis, metastasis, tumour immunity, maintenance of the tumour microenvironment and apoptosis.  The molecular mechanism of action of MKIs is brought about through the simultaneous inhibition of several kinase enzymes, rather than predominantly inhibiting a single kinase, as is the case for selective kinase inhibitors (see Mechanism of Multikinase inhibitor Action ).

This website was originally created in 2014 when it was found that there was a lack of guidelines for managing these skin toxicities associated with MKIs. Since then the use of such inhibitors has expanded further but the lack of evidence-based recommendations for managing such toxicities remains an issue. The website has therefore been updated in 2019 with the objective to continue to provide a relevant, valuable resource for healthcare professionals. Furthermore, in addition to the MKIs described in the 2014 version of the website (regorafenib, sorafenib, vandetanib, sunitinib, imatinib mesylate), two more approved prior to 2014 have been included (dasatinib and pazopanib) and three more have been approved since (lenvatinib, cabozantinib and midostaurin).

Information included in this website is compiled from review of the medical literature and expert guidance from a dermatologist, Siegfried Segaert, MD, PhD (Belgium), medical oncologists, Guillem Argilés MD, PhD (Spain) and Josep Tabernero, MD, PhD (Spain), and two clinical nurse specialist/researchers, Paz Fernández Ortega, PhD, MSc, RN, Psych (Spain) and Christine Boers-Doets, MSc (The Netherlands).

We aim to:

  1. Explore the side effects of inhibiting receptor tyrosine kinases (RTK)
  2. Provide expert advice on the prophylaxis and treatment of skin toxicities
  3. Provide recommendations on how to manage side effects while maintaining treatment with multikinase inhibitors 

Skin Toxicities Associated With Multikinase Inhibitors

Skin toxicity profiles of each targeted therapy are shown below. Further information on each side effect can be found by clicking on each one.

The information provided is based on data included in the Summary of Product Characteristics (SPC) and Prescribing Information for the respective MKIs with input from the team of experts involved in building this website. It focuses on what are the commonly observed side effects in real-life clinical practice.

Table 1: Skin Toxicities associated with multikinase inhibitors