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Most patients experience skin-related adverse events during EGFRI treatment.1,2,3,4,5,6,7,8 While these events are predominantly mild, approximately 10% of patients experience moderate to severe adverse events.5,7 As skin reactions tend to vary between patients and show different kinetics for antibodies (more rapid onset around days 2-3, with a maximum after 2-3 weeks) and Tyrosine kinase inhibitors (slower onset),8 data on incidence and course can be unreliable and may be better substituted by the figure below, which takes into account the specific literature.5,7,8,9

Onset and time course of skin reactions during EGFRI-treatment

Onset and time course of skin reactions during EGFRI-treatment. Adapted from: Segaert S et al. Eur J Cancer 2009; 45(Suppl 1): 295-308; Roé E et al. J Am Acad Dermatol 2006; 55: 429-437; Osio A et al. Br J Dermatol 2009; 161: 515-521.

The figure gives a semi-quantitative and more qualitative graphical impression of the proportion of patients that can be expected to experience the respective adverse event, the typical time courses of onset (ie early = within 1 month, intermediate = within 1-6 months, and late = 6 months and later) and resolution after completion of treatment.7,8,9 The figure (adapted from references7,8,9) also reflects the experience that skin changes gradually improve if treatment is continued over time, and that skin reactions are sensitive to supportive skin management.

References

1European Medicine Agency. Tarceva® (erlotinib) Summary of Product Characteristics 2009.
2European Medicine Agency. Iressa® (gefitinib) Summary of Product Characteristics 2009.
3European Medicine Agency. Erbitux® (cetuximab) Summary of Product Characteristics 2009.
4European Medicine Agency. Tyverb® (lapatinib) Summary of Product Characteristics 2010.
5Lacouture ME. Nat Rev Cancer 2006; 6: 803-812.
6European Medicine Agency. Vectibix® (panitumumab) Summary of Product Characteristics 2009.
7Segaert S et al. Eur J Cancer 2009; 45(Suppl 1): 295-308.
8Roé E et al. J Am Acad Dermatol 2006; 55: 429-437.
9Osio A et al. Br J Dermatol 2009; 161: 515-521.

Page last updated in 2009.

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