Original Study: Skin manifestations of gefitinib and the association with survival

Skin manifestations of gefitinib and the association with survival of advanced non-small-cell lung cancer in Taiwan

Dermatologica Sinica. Volume 29, Issue 1 , Pages 13-18, March 2011

Abstract 

Background

Epidermal growth factor receptor antagonists, such as gefitinib, erlotinib, and cetuximab, have been used in treating carcinomas. The efficacies have been proposed to correlate with skin reactions, but the most important predictive indicator is still unknown. Our aim was to investigate the types of skin toxicities and to analyze the major therapeutic predictive indicators in Taiwan.

Methods

A retrospective analysis was used to study 68 patients with advanced non-small-cell lung cancer receiving gefitinib.

Results

Acneiform eruption (41.2%), xerosis (38.2%), pruritus (26.5%), and paronychia (16.2%) composed most of the skin reactions. The univariate analysis revealed paronychia as the most substantial survival predictive indicator (p=0.0427). In the multivariate analysis, older patients with paronychia had better prognosis (p=0.0050). Women tended to develop paronychia (p=0.1098). Xerosis positively correlated with paronychia (p=0.0082).

Conclusion

Paronychia is the most indicative survival predictive factor among the skin manifestations, and it correlates with age, gender, and xerosis. Elucidation of the relationship between cutaneous reactions can provide information on the epidermal growth factor receptor signaling mechanism of skin.

Keywords: Gefitinib, Non-small-cell lung cancer, Paronychia, Predictive factor, Skin toxicities (cutaneous adverse reactions)

Authors:

• Shiou-Han Wang

  Affiliations

  • Department of Dermatology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
  • 
    
• Chih-Hsin Yang

  Affiliations

  • Department of Oncology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
  • 
    
• Hsien-Ching Chiu

  Affiliations

  • Department of Dermatology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
  • 
    
• Fu-Chang Hu

  Affiliations

  • National Center of Excellence for General Clinical Trial and Research, National Taiwan University Hospital and College of Public Health, National Taiwan University, Taipei, Taiwan
  • 
    
• Chih-Chieh Chan

  Affiliations

  • Department of Dermatology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
  • 
    
• Yi-Hua Liao

  Affiliations

  • Department of Dermatology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
  • 
    
• Hsiao-Chin Chen

  Affiliations

  • Department of Dermatology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
  • 
    
• Chia-Yu Chu

  Affiliations

  • Department of Dermatology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
  • Corresponding author. Department of Dermatology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan.

Received 23 September 2010;

received in revised form 26 January 2011;

accepted 8 February 2011.

published online 21 March 2011.