John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Management of skin toxicity of molecular targeted drugs Volume 17, special issue 4, Prise en charge de la toxicité de la chimiothérapie anticancéreuse et soins de support en oncologie digestive

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Service de dermatologie, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69645 Pierre Bénite, France

Molecular targeted drugs, especially epithelial growth factor receptor inhibitors (EGFRI) combine higher efficiency treatment against tumours and less toxicity than traditional chemotherapeutics. Acneiform eruption in sebaceous areas is the most common cutaneous reactions of EGFRI: its intensity is dose and patient dependent. Severity of the skin rash is associated with EGFRI treatment efficiency but might be a drawback to treatment compliance. Some other cutaneous toxicity reactions can be enhanced like xerosis with scaly, painful fissures in hands and feet, paronychia, hair abnormality, trichomegaly of eyelashes. Managing EGFRI treatments in balance with skin toxicity is a promising way to minimise the detrimental effects of the rash on patients, improve their quality of life without sacrificed the treatment efficiency. No evidence-based treatment guidelines nowadays exist. However expert panels recommend a multidisciplinary approach including patient education and use of a grade-based treatment algorithm. Greater knowledge of skin biology and of individual variability factors will lead to a better use of EGFRI treatment and consequently will diminish the cutaneous toxicity.