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With the use of EGFRIs in the adjuvant setting, and as clinical outcomes become increasingly positive, EGFRI-mediated skin toxicity will continue to attract attention.1

The effect of the rash on quality of life has not been formally assessed, but it is expected to be significant, on the basis of the occurrence of toxicities on visible body sites and the associated symptoms. More practical tools that better assess risk factors for severe skin reactions during EGFRI treatment are warranted in addition to scientific strategies for the identification of risk phenotypes or genotypes (eg presence of EGFR Homodimers2 and Cysteine-adenosine repeat polymorphisms 3, measurement of average EGFRI plasma concentrations during the first 24 hours after the first dose4 and COX2 expression levels within the tumour tissue5).

This section, ‘Background research’, provides information relating to the current understanding of the physiology and pathophysiology of the skin reactions associated with EGFRI treatment, and contains a compilation of ongoing research efforts in the field.

References

1Lacouture ME. Nat Rev Cancer 2006; 6: 803-812.
2Laux I et al. Br J Cancer 2006; 94: 85-92.
3Perea S et al. J Clin Oncol ASCO Annual Meeting Proceedings (Post-Meeting Edition) 2004; 22(14S); 3005.
4Hidalgo M et al. J Clin Oncol 2001; 19: 3267-3279.
5Vallböhmer D et al. J Clin Oncol 2005; 23: 3536-3544.

Pathophysiology

Structure of skin and hair follicles, the effects of EGFRI on the skin and the mechanism of EGFRI action.

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