Pre-emptive Treatment Helped Curtail Skin Toxicity Associated with Colon Cancer Drug
With a pre-emptive, prophylactic skin
regimen, patients who receive panitumumab for treatment of metastatic colorectal
cancer may be able to avoid some of the skin-associated toxicities, according to
data being presented at the 2009 ASCO Annual in Orlando. (Abstract #
CRA4027).
Edith Mitchell, M.D., a clinical
professor in the Department of Medical Oncology at Jefferson Medical College of
Thomas Jefferson University, presented data from the STEPP (Skin Toxicity
Evaluation Protocol with Panitumumab) trial, which was the first prospective
study to compare pre-emptive and reactive skin treatment for skin toxicities
related to panitumumab.
Skin toxicities are the most common
adverse effects related to panitumumab (Vectibix) and cetuximab (Erbitux), which
are fully human monoclonal antibodies that target the epidermal growth factor
receptor (EGFR). The toxicities affect approximately 90 percent of patients who
receive panitumumab, and could include erythema, dermatitis, pruritus, pustules,
rash, and hair and nail changes.
“Panitumumab and the other EGFR
inhibitors are now key components to the treatment strategies for metastatic
colorectal cancer,” Dr. Mitchell said. “But the majority of the patients who
receive these agents suffer from skin toxicities, and for some patients,
treatment must be interrupted or discontinued. If we can prevent or minimize
these toxicities, it would be a significant advance in patient care.”
The researchers studied 95 patients
receiving panitumumab in combination with irinotecan-based chemotherapy. The
patients were randomized to receive pre-emptive skin toxicity treatment
initiated 24 hours prior to the first dose of panitumumab, then given daily
through week six, or reactive skin treatment after the skin toxicity developed.
Forty-eight patients received the pre-emptive treatment, which included
moisturizers, sunscreen, topical steroids and oral doxycycline.
The primary endpoint was the incidence of
specific grade 2 or higher skin toxicities during the six week skin treatment
period. In the six-week period, 29 percent of patients who received pre-emptive
treatment developed the skin toxicities, compared with 62 percent of the
patients who did not receive pre-emptive treatment.
Quality of life was also assessed, using
the Dermatology Life Quality Index. Patients who received the pre-emptive,
prophylactic skin treatment regimen reported an improved quality of life, even
around week three, which was the median time to first grade 2 or higher skin
toxicity in the reactive skin treatment group.
Media Only Contact:
Emily Shafer
Thomas Jefferson University Hospital
Phone: (215) 955-6300
Published: 6/1/2009