Profile of Dermatologic Side Effects of Tyrosine Kinase Inhibitor (EGFR-TKIs) in Lung Cancer Patients

https://doi.org/10.22146/jmpf.91322

Elfrida Napitupulu(1), Arief Nurrochmad(2*), Arif Riswahyudi Hanafi(3), Danang Tri Wahyudi(4)

(1) *) Magister of Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Sekip Utara Yogyakarta 55281 *) Dharmais Cancer Hospital, Jl. Letjen. S. Parman No.84-86, Jakarta Barat, Jakarta
(2) Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta 55281
(3) Dharmais Cancer Hospital, Jl. Letjen. S. Parman No.84-86, Jakarta Barat
(4) Dharmais Cancer Hospital, Jl. Letjen. S. Parman No.84-86, Jakarta Barat, Jakarta
(*) Corresponding Author

Abstract


Background: Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor (EGFR-TKIs) drugs are commonly used target therapies in patients with advanced-stage non-small cell carcinoma lung cancer (NSCLC).

Objectives: This study aims to provide an overview of dermatologic side effects and quality of life index of NSCLC patients who received EGFR-TKIs targeted therapy at Dharmais Cancer Hospital.

Methods: This study used a cross-sectional design. Inclusion criteria were patients who received EGFR-TKIs targeted therapy, namely gefitinib, erlotinib, and afatinib, in September - October 2023, who were willing to be research subjects, and patients who were not in a medical emergency. In total, 52 patients filled out the dermatology life quality index (DLQI) questionnaire through interviews and medical records. Data evaluation was performed descriptively in the form of percentages.

Results: The most common occurrence of dermatologic side effects was skin hypersensitivity reactions with mild severity (grade 1) by 59.6%, moderate severity (grade 2) by 19.2%, and severe severity (grade 3) by 1.9%, and no drug dermatologic side effects by 19.2%. In comparison, the most DLQI was in the category of not affecting patient life. In general, side effects with moderate (grade 2) and severe (grade 3). The severity will decrease to mild severity (grade 1) when already getting topical corticosteroid drugs or combinations with oral antibiotics and antihistamine drugs.

Conclusion: The most severe side effect was grade 1, which slightly affected the patient's quality of life. Education and monitoring of side effects and management of symptoms are necessary to reduce the severity and improve patients' quality of life.


Keywords


Dermatologic side effects; DLQI; EGFR-TKIs; Non-small cell lung cancer (NSCLC)

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References

  1. Komite Nasional Penaggulangan Kanker. Pedoman Nasional Pelayanan Kedokteran Kanker Paru. Jakarta: Kementerian Kesehatan Republik Indonesia; 2017. 88 p.
  2. Zhao Y, Cheng B, Chen Z, Li J, Liang H, Chen Y, et al. Toxicity profile of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung cancer: A systematic review and network meta-analysis. Crit Rev Oncol Hematol. 2021;160:103305. doi:10.1016/j.critrevonc.2021.103305
  3. Kementerian Kesehatan RI. Keputusan Menkes Republik Indonesia No. HK.01.07/Menkes/6485/2021 Tentang Formularium Nasional. Kementerian Kesehatan Republik Indonesia; 2021. 167 p.
  4. Colombino M, Paliogiannis P, Cossu A, Santeufemia DA, Sardinian Lung Cancer Study G, Sini MC, et al. EGFR, KRAS, BRAF, ALK, and cMET genetic alterations in 1440 Sardinian patients with lung adenocarcinoma. BMC Pulm Med. 2019;19(1):209. doi:10.1186/s12890-019-0964-x
  5. Fatmawati F. Profil Pasien Kanker Paru Jenis Karsinoma Bukan Sel Kecil Yang Mendapatkan Inhibitor Tirosin Kinase Sebagai Terapi Lini Pertama di RSUD Dr. Soetomo. Thesis. Universitas Airlangga; 2016.
  6. Macdonald JB, Macdonald B, Golitz LE, LoRusso P, Sekulic A. Cutaneous adverse effects of targeted therapies: Part I: Inhibitors of the cellular membrane. J Am Acad Dermatol. 2015;72(2):203-18. doi:10.1016/j.jaad.2014.07.032
  7. Chen JY, Liang SK, Chuang TY, Chu CY, Tu CH, Yeh YJ, et al. The impact of comorbidities, neutrophil-to-lymphocyte ratio, and drug toxicities on quality of life in lung cancer patients receiving EGFR-TKI therapy. J Formos Med Assoc. 2024;123(2):198-207. doi:10.1016/j.jfma.2023.07.017
  8. Giuliani J, Bonetti A. The Pharmacological Costs for the Management of Skin Toxicity in Patients With Cancer Treated With Epidermal Growth Factor Receptor-Inhibitors. Clin Lung Cancer. 2016;17(6):471-3. doi:10.1016/j.cllc.2016.04.006
  9. Tseng LC, Chen KH, Wang CL, Weng LC. Effects of tyrosine kinase inhibitor therapy on skin toxicity and skin-related quality of life in patients with lung cancer: An observational study. Medicine (Baltimore). 2020;99(23):e20510. doi:10.1097/MD.0000000000020510
  10. Chan JC, Lee YH, Liu CY, Shih HH, Tsay PK, Tang WR. A Correlational Study of Skin Toxicity and Quality of Life in Patients With Advanced Lung Cancer Receiving Targeted Therapy. J Nurs Res. 2019;27(6):e51. doi:10.1097/jnr.0000000000000339
  11. Neo AG, Perez A, Lopez C, Castedo L, Tojo G. Photocyclization of tosylstilbenes as a key reaction in the preparation of an analogue of the antitumor agent CC-1065. J Org Chem. 2009;74(8):3203-6. doi:10.1021/jo900140t
  12. Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)--a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210-6. doi:10.1111/j.1365-2230.1994.tb01167.x
  13. Rahmatina. Uji validitas dan reliabilitas Dermatology Life Quality Index (DLQI) berbahasa indonesia pada pasien di Poliklinik Ilmu Kesehatan Kulit Dan Kelamin Rumah Sakit Dr Cipto Mangunkusumo = Validity and reliability test of Indonesian version of Dermatology Life Quality Index (DLQI) on patients attending the dermatovenereology clinic at Dr Cipto Mangunkusumo Hospital. Jakarta. Thesis. Universitas Indonesia; 2013.
  14. U.S. Department of Health and Human Services. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 2017. https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcae_v5_quick_reference_5x7.pdf. Published November 27, 2017. Accessed August 6, 2024.
  15. Ding PN, Lord SJ, Gebski V, Links M, Bray V, Gralla RJ, et al. Risk of Treatment-Related Toxicities from EGFR Tyrosine Kinase Inhibitors: A Meta-analysis of Clinical Trials of Gefitinib, Erlotinib, and Afatinib in Advanced EGFR-Mutated Non-Small Cell Lung Cancer. J Thorac Oncol. 2017;12(4):633-43.
  16. Joshi SS, Ortiz S, Witherspoon JN, Rademaker A, West DP, Anderson R, et al. Effects of epidermal growth factor receptor inhibitor-induced dermatologic toxicities on quality of life. Cancer. 2010;116(16):3916-23. doi:10.1002/cncr.25090
  17. Charles C, Bungener C, Razavi D, Mateus C, Routier E, Lanoy E, et al. Impact of dermatologic adverse events induced by targeted therapies on quality of life. Crit Rev Oncol Hematol. 2016;101:158-68. doi:10.1016/j.critrevonc.2016.03.003
  18. Masago K, Imamichi F, Masuda Y, Ariga N, Fujitomi K, Fukumine Y, et al. Team Management of Skin Rash Associated with Use of Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors. Asia Pac J Oncol Nurs. 2018;5(4):430-4. doi:10.4103/apjon.apjon_33_18
  19. Preedy VR, Watson RRR. Handbook of disease burdens and quality of life measures. Handbook of disease burdens and quality of life measures. 2010. p. 6. v-. v.
  20. Passaro A, Di Maio M, Del Signore E, Gori B, de Marinis F. Management of nonhematologic toxicities associated with different EGFR-TKIs in advanced NSCLC: a comparison analysis. Clin Lung Cancer. 2014;15(4):307-12. doi:10.1016/j.cllc.2014.04.006
  21. Annunziata MC, Ferrillo M, Cinelli E, Panariello L, Rocco D, Fabbrocini G. Retrospective Analysis of Skin Toxicity in Patients under Anti-EGFR Tyrosine Kinase Inhibitors: Our Experience in Lung Cancer. Open Access Maced J Med Sci. 2019;7(6):973-7.
  22. Laitupa AAW, L. Efficacy of Gefitinib and Erlotinib in Non-Small-Cell Lung Carcinoma. The New Armenian Medical Journal. 2019;13(3):4-10.



DOI: https://doi.org/10.22146/jmpf.91322

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