Reactive management

Reactive management of hair changes induced by multikinase inhibitor treatment

General recommendation: Excessive hair growth and alopecia can cause embarrassment and psychological distress. Patients can be reassured that, in most cases, hair growth will normalise after completion of treatment.¹

Treatment overview

Non-scarring alopecia may occur after 2-3 months of treatment and usually resolves after discontinuation of treatment, although altered hair regrowth is sometimes observed.^{2, 3} Minoxidil is used to treat non-scarring alopecia in the general population.² If given to patients receiving targeted therapy, pruritus and hypertrichosis should be monitored.²

Table 34. Management of hair changes associated with multikinase inhibitors^1-3

	Management of hair changes
Alopecia, non-scarring	Minoxidil 2% or 5% bid
Alopecia, scarring	Class 1 steroid lotion, shampoo, or foam Antibiotic lotion

Products

Minoxidil 2% or 5% twice daily
Steroid lotion, shampoo or foam
Eflornithine

Multikinase inhibitor treatment

Continue with/withhold the selected multikinase inhibitor treatment regimen, as recommended in the current and relevant SPC and according to the patient’s condition.

References

Boers-Doets CB. The TARGET SYSTEM. Approach to assessment, grading, and management of dermatological & mucosal side effects of targeted anticancer therapies. ISBN 978-94-92070-00-5. 2014.
Lacouture ME, et al. MASCC Skin Toxicity Study Group. Support Care Cancer. 2011; 19: 1079-95.
Suchonwanit P. and McMichael A.J. Am J of Clin Dermatol. 2018; 19:853-865.