Increasing adherence to evidence-based prophylaxis protocols for epidermal growth factor receptor inhibitor (EGFRi)-associated rash can reduce interventions and toxicity-associated chemotherapy interruptions, according to a study published online July 1 in JAMA Dermatology.
Zizi Yu, from Harvard Medical School in Boston, and colleagues examined the impact of adherence to prophylaxis guidelines for prevention of EGFRi-associated cutaneous toxic effects. Data were included for 118 patients treated with cetuximab in 2012 (two years after publication of the Skin Toxicity Evaluation Protocol With Panitumumab) and 90 treated with cetuximab in 2017 (two years after full implementation of the Skin Toxicities from Anticancer Therapies program).
The researchers found that 25 percent of patients treated in 2012 and 47 percent treated in 2017 were prophylactically treated for skin toxicity at cetuximab initiation. From 2012 to 2017, there were increases noted in preemptive tetracycline use (45 to 71 percent) and topical corticosteroid use (7 to 57 percent), while use of topical antibiotics decreased (79 to 43 percent). The incidence of rash did not differ by prophylaxis status. Compared with those not prescribed prophylactic treatment, patients prescribed prophylactic treatment were less likely to require a first or second rescue treatment for rash (adjusted odds ratios, 0.06 and 0.26, respectively) or to experience a cetuximab dose change or interruption (adjusted odds ratio, 0.21).
“The results of this study highlight the value of integrating dermatologic care and education into oncology centers,” the authors write.
Two authors disclosed financial ties to the biopharmaceutical industry.