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| |  Prophylactic Skin Care Markedly Reduces Complications in Colorectal Cancer Patients Receiving Treatment With Panitumumab: Presented at ASCO-GI By Ed Susman SAN FRANCISCO -- January 19, 2009 -- Simple steps to prevent skin rashes -- such as using sunscreen and careful cleansing -- appear to help reduce the risk of complications among patients taking the targeted agent panitumumab for treatment of colorectal cancer. Patients who receive treatment with an epidermal growth factor receptor inhibitor are known to frequently develop skin acne-like rashes. The incidence of grade 2 or greater skin toxicities during the 6-week treatment period was reduced by more than 50% in patients following prophylactic skin-treatment measures compared with the group following reactive skin-treatment measures, said Edith Mitchell, MD, Department of Medical Oncology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania. Dr. Mitchell discussed the results of her study in an oral presentation on January 17 here at the American Society of Clinical Oncology's 6th Gastrointestinal Cancers Symposium (ASCO-GI), which was cosponsored by the American Gastrointestinal Association Foundation, the American Society for Radiation Oncology, and the Society of Surgical Oncology. For the study, patients who were taking panitumumab along with a regimen of 5-fluorouracil, leucovorin, and irinotecan were randomly assigned to prophylactic skin-care measures or to treat the skin reactions after the outbreaks occurred. Patients assigned to prophylactic care (n = 48) were told to use a skin moisturiser in the morning and a 1% topical steroid at bedtime on the face, hands, feet, neck, back, and chest. They were also advised to use a sunscreen with a SPF greater than 15 whenever being exposed to sunlight and were prescribed doxycycline 100 mg twice daily. Patients assigned to reactive skin care (n = 47) received treatment for any skin reactions at the discretion of the clinicians. Patients were followed for 31 weeks in the prophylactic arm and 40 weeks in the reactive skin-care arm. More than half of the patients in each group were men. All of the participants had good performance status. All had metastatic colon cancer, and more than half of the patients had more than 1 metastatic site. Dr. Mitchell said that the prophylactic treatment proved more successful in preventing skin complications that reactive treatment. Grade 3 acneiform reactions occurred in 4% of the prophylactic-treatment group and 21% of the reactive-therapy group. Grade 3 pruritis occurred among 2% and 11% of patients, respectively. Grade 3 pustular rash occurred in 4% and 17% of patients, respectively. No grade 3 paronychia occurred among the prophylactic-care patients, but was observed in 6% of the reactive-care group. Dr. Mitchell also noted that patients doing the prophylactic skin care reported less deterioration in quality-of-life measures. Funding for this study was provided by Amgen.
[Presentation title: Impact of Pre-Emptive Skin Toxicity (ST) Treatment (Tx) on Panitumumab (Pmab)-Related Skin Toxicities and Quality of Life (QOL) in Patients (Pts) With Metastatic Colorectal Cancer (mCRC): Results From STEPP. Abstract 291]
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