Management of cutaneous adverse events induced by anti-EGFR (epidermal growth factor receptor): A French interdisciplinary therapeutic algorithm

Abstract

Purpose Cutaneous adverse events induced by epidermal growth factor receptor (EGFR) inhibitors can hamper the patients' quality of life. The aim of our work was to draft an algorithm for the optimised management of this skin toxicity. Methods This algorithm was built in three steps under the responsibility of a steering committee. Step I: a systematic literature analysis (SLA) has been performed. Step II: the collection of information about practices was performed through a questionnaire.These questions were asked during regional meetings to which oncologists, gastro-enterologists, radiotherapists, and dermatologists were invited. Step III: a final meeting was organised involving the bibliography group and the steering committee and regional scientific committees for proposing a final algorithm. Results Step I: 14 publications were selected to evaluate the use of cyclines as curative or prophylactic treatment of the folliculitis induced by EGFR inhibitors. Nineteen publications were retained for the topical treatment of the folliculitis. Fortysix articles were selected for the management of the cutaneous lesions in linkwith appendages and 12 for xerosis and pruritus. Step II: 96 delegates attended the seven regional meetings and 67 questionnaireswere analysed. Step III: a final algorithmwas proposed on the basis of the conclusions of the first two steps and expert opinions present at this final meeting. The different propositions were unanimously approved by the 14 experts who voted. Conclusions This multidisciplinary study summarising published data and current practices produced a therapeutic algorithm, which should facilitate the standardised, optimized management of skin toxicity associated with EGFR inhibitors in France.© 2012 Springer-Verlag.