Life-threatening dermatologic adverse events in oncology

Alyx C. Rosen, Yevgeniy Balagula, Dennis W. Raisch, Vishvas Garg, Beatrice Nardone, Nicole Larsen, Jennifer Sorrell, Dennis P. West, Milan J. Anadkat, Mario E. Lacouture*

*Corresponding author for this work

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

The incidences of life-threatening toxicities such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are inconsistently reported. The potential association of anticancer agents with SJS or TEN has not been systematically investigated. We searched the literature (Ovid: 1950 to June 2013 and PubMed: 1948 to June 2013) using terms for SJS/TEN and anticancer therapies. Primary case reports, case series, and clinical trials were included. In addition, MedWatch, the Food and Drug Administration Adverse Event Reporting System (FAERS), was searched (1968 to August 2012) for SJS/TEN reports associated with anticancer therapies. Proportional reporting ratios (PRR>2, N>3), empirical Bayes geometric mean (EBGM>2, N>3), and lower 95% confidence interval (EBGM0.05>2) were used as thresholds to constitute a signal of association between SJS/TEN and anticancer drugs. There were 46 SJS and 37 TEN cases associated with 18 and 22 anticancer drugs in the literature, respectively. Among cases in the FAERS, significant signals were associated with SJS for bendamustine and with TEN for bendamustine, busulfan, chlorambucil, fludarabine, lomustine, and procarbazine. Several drugs reported in the published literature to be associated with SJS/TEN were not found to have significant signals in FAERS. Proactive pharmacovigilance to detect and define safety signals serves to aid oncology practitioners in the recognition of possible, yet uncommon, serious, and/or life-threatening skin reactions.

Original languageEnglish (US)
Pages (from-to)225-234
Number of pages10
JournalAnti-Cancer Drugs
Volume25
Issue number2
DOIs
StatePublished - Jan 1 2014

Keywords

  • Stevens-Johnson syndrome
  • adverse drug event
  • chemotherapy
  • toxic epidermal necrolysis

ASJC Scopus subject areas

  • Oncology
  • Pharmacology
  • Pharmacology (medical)
  • Cancer Research

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  • Cite this

    Rosen, A. C., Balagula, Y., Raisch, D. W., Garg, V., Nardone, B., Larsen, N., Sorrell, J., West, D. P., Anadkat, M. J., & Lacouture, M. E. (2014). Life-threatening dermatologic adverse events in oncology. Anti-Cancer Drugs, 25(2), 225-234. https://doi.org/10.1097/CAD.0000000000000032