Inhibition of the epidermal growth factor receptor (EGFR) extends patient survival in multiple tumor types. However, EGFR inhibition is associated with skin toxicities such as mild to moderate acneiform rash, which can be severe in up to 18% of patients. A previously performed structured literature search revealed an unmet need for research regarding the influence of dermatologic adverse events (dAEs) on patients’ quality of life (QoL), patient acceptance of cancer treatments, and therapeutic risk/benefit tradeoff from the patients’ perspective. This survey reports on these topics in patients who received the anti-EGFR monoclonal antibody cetuximab.
Using a multinational survey that included 195 patients, we conducted a subanalysis of 66 patients who previously received cetuximab-based cancer therapy (44 with metastatic colorectal cancer [mCRC] and 22 with squamous cell carcinoma of the head and neck [SCCHN]) to gauge attitudes regarding skin toxicities.
64/66 patients (43/44 with mCRC and 21/22 with SCCHN) experienced dAEs. Skin toxicities were cited as causing pain and physical discomfort as well as impairing QoL. Despite the negative social, physical, and functional impacts of dAEs, 70% of patients with mCRC and 64% of patients with SCCHN who received cetuximab stated that they would prefer a more efficacious cancer therapy that induced more severe skin reactions over a less efficacious therapy associated with less severe skin reactions. Furthermore, in an efficacy-safety tradeoff exercise, nearly two-thirds of patients (65%) stated that they would accept a new therapy with improved efficacy, even if 1 out of every 2 patients experienced a severe skin rash on this therapy.
Patients with mCRC or SCCHN who previously received the anti-EGFR antibody cetuximab as part of their cancer therapy were willing to accept skin toxicities as an AE if these toxicities were the anticipated byproduct of a more effective therapeutic regimen.
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Legal entity responsible for the study
Merck KGaA, Darmstadt, Germany
Merck KGaA, Darmstadt, Germany Disclosure: P. Ronga: Employee of Merck KGaA M.E. Lacouture: Consulting:AZ, BI, Dignitana, Foamix, Genentech, Janssen R&D, Merck S-D, EMD Serono, Michaels Mission, NVS, Oncology Training International, Quintiles, RP Pharmaceuticals; Research Grants: Berg, BMS, Roche. Funded in part by NIH Support Grant P30 CA008748 All other authors have declared no conflicts of interest.