Tyrosine kinase inhibitors (TKIs) are a pharmaceutical class of small molecules, orally available with manageable safety profile, approved worldwide for the treatment of several neoplasms, including lung, breast, kidney and pancreatic cancer as well as gastro-intestinal stromal tumours and chronic myeloid leukaemia. In recent years, management of lung cancer has been moving towards molecular-guided treatment, and the best example of this new approach is the use of the tyrosine kinase inhibitors (TKIs) in patients with mutations in the epidermal growth factor receptor (EGFR). The identification of molecular predictors of response can allow the selection of patients who will be the most likely to respond to these tyrosine kinase inhibitors (TKIs). Gastrointestinal (GI) adverse events (AEs) are frequently observed in patients receiving EGFR tyrosine kinase inhibitor therapy and are most impactful on the patient's quality of life. Dermatologic side effects are also relatively common among patients treated with EGFR inhibitors. Evidence has emerged in recent years to suggest that the incidence and severity of rash, positively correlated with response to treatment.These skin disorders are generally mild or moderate in severity and can be managed by appropriate interventions or by reducing or interrupting the dose. Appropriate and timely management make it possible to continue a patient's quality of life and maintain compliance; however if these adverse events (AEs) are not managed appropriately, and become more severe, treatment cessation may be warranted compromising clinical outcome. Strategies to improve the assessment and management of TKI related skin AEs are therefore essential to ensure compliance with TKI therapy, thereby enabling patients to achieve optimal benefits. This article provides a consensus on practical recommendation for the prevention and management of diarrhoea and rash in Non-Small Cell Lung Cancer (NSCLC) patients receiving TKIs.
[1]
N. Yamazaki,et al.
Erlotinib-related skin toxicities: treatment strategies in patients with metastatic non-small cell lung cancer.
,
2013,
Journal of the American Academy of Dermatology.
[2]
J. Köhler,et al.
Diarrhea associated with afatinib: an oral ErbB family blocker
,
2013,
Expert review of anticancer therapy.
[3]
A. Hauschild,et al.
Dermatologic adverse events associated with afatinib: an oral ErbB family blocker
,
2013,
Expert review of anticancer therapy.
[4]
S. Barni,et al.
Relationship between skin rash and outcome in non-small-cell lung cancer patients treated with anti-EGFR tyrosine kinase inhibitors: a literature-based meta-analysis of 24 trials.
,
2012,
Lung cancer.
[5]
G. Altavilla,et al.
Tyrosine kinase inhibitors for non-small-cell lung cancer: finding patients who will be responsive
,
2011,
Expert review of respiratory medicine.
[6]
E. Van Cutsem,et al.
Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors.
,
2005,
Annals of oncology : official journal of the European Society for Medical Oncology.