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Efficacy and Skin Toxicity Management with Cetuximab in Metastatic Colorectal Cancer: Outcomes from an Oncologic/Dermatologic Cooperation

2008; Elsevier BV; Volume: 7; Issue: 1 Linguagem: Inglês

10.3816/ccc.2008.n.007

1938-0674

Patrizia Racca, Laura Fanchini, Virginia Caliendo, Giuliana Ritorto, W. Evangelista, Roberta Volpatto, E. Milanesi, Angelica Ciorba, Myriam Paris, Ivan Facilissimo, Giuseppe Macripò, Mario Clerico, Libero Ciuffreda,

Cancer Diagnosis and Treatment

Purpose The aim of this study was to investigate the efficacy of the combination of irinotecan/cetuximab and to plan related skin toxicity management with an oncologic/dermatologic team. Patients and Methods Thirty-four patients with epidermal growth factor receptor (EGFR)–expressing metastatic colorectal cancer received cetuximab 400 mg/m2 as an initial dose and 250 mg/m2 weekly thereafter. In addition, patients received irinotecan 180 mg/m2 every 2 weeks. Results Thirty-two patients were evaluated for response rate (RR) and skin toxicity to establish the best management. In our study, the responses observed with cetuximab treatment were complete response in 1 patient (3%), partial response in 11 patients (34%), disease stabilization in 6 patients (19%), and progressive disease in 14 patients (44%). Of 34 patients evaluable for cutaneous toxicity, 10 patients (29%) presented with grade 1 eruption, 13 (38%) with grade 2 eruption, and 4 (12%) with grade 3 eruption. Allergic reactions such as flushing and urticaria (grade 2) were seen in 2 patients (6%). Conclusion Cutaneous reactions consisted of follicular rash, xerosis, painful fissures in palms and soles, alterations in hair growth, and mucositis. In the majority of patients (80%-90%), the worst recorded skin effects were mild (grade 1) to moderate (grade 2). The incidence of severe cases (grade 3) was approximately 15%. All dermatologic effects were reversible and generally without sequelae within 4 weeks after treatment discontinuation. We observed significant correlations between degree of cutaneous toxicity and increased RR. Correct identification and treatment by oncologic/dermatologic cooperation of EGFR cutaneous side effects help to improve quality of life.