TY - JOUR
T1 - Osimertinib
T2 - A Novel Dermatologic Adverse Event Profile in Patients with Lung Cancer
AU - Chu, Chia Yu
AU - Choi, Jennifer
AU - Eaby-Sandy, Beth
AU - Langer, Corey J.
AU - Lacouture, Mario E.
N1 - Funding Information:
The authors thank Alanna Kennedy, Ph.D., and Marissa Nolan, Ph.D., of the Lockwood Group (Stamford, CT) for providing medical writing support, which was in accordance with Good Publication Practice (GPP3) guidelines and funded by AstraZeneca (Wilmington, DE). Additional editorial support was provided by Oxford PharmaGenesis (Oxford, UK) and was funded by AstraZeneca (Wilmington, DE). Support for the retrospective case reviews was provided by the National Taiwan University Hospital (grant 106-S3535 to C.Y.C.) and AstraZeneca (to M.E.L.). M.E.L. is supported in part by the NIH/NCI Cancer Center Support Grant P30-CA008748.
Publisher Copyright:
© AlphaMed Press 2018
PY - 2018/8
Y1 - 2018/8
N2 - Dermatologic adverse events (dAEs) are common with the use of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. First- and second-generation agents (erlotinib, gefitinib, and afatinib) are frequently associated with acneiform rash, pruritus, xerosis, and paronychia; the incidence and characterization of these dAEs have been well described. However, there is evidence that the dAE profile is different with third-generation EGFR-TKIs. Herein, we describe the dAEs associated with third-generation EGFR-TKIs and our clinical experience with osimertinib, a third-generation EGFR-TKI approved by the U.S. Food and Drug Administration for the treatment of metastatic, EGFR T790M mutation-positive non-small cell lung cancer in patients whose disease has progressed on or after EGFR-TKI therapy. Case summaries of patients from two of our institutions who received osimertinib and were referred to a dermatologist for dAEs are also presented. Overall, the evidence suggests that osimertinib is associated with less severe and less frequent dAEs than first- and second-generation EGFR-TKIs and that therefore a different approach is warranted. Finally, we outline dAE management approaches for osimertinib in the context of those typically employed with first- and second-generation EGFR-TKIs. Implications for Practice: Appropriate prevention and management of dermatologic adverse events (dAEs) associated with the use of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) may help patients to continue therapy and lessen any negative impact on their quality of life. EGFR-TKIs are frequently associated with acneiform rash, pruritus, xerosis, and paronychia; however, dAEs associated with third-generation EGFR-TKIs are lower in frequency and severity. Before therapy, health care providers should discuss the potential osimertinib-associated dAEs and encourage patients to report their dAEs. Patients should also be educated on prophylactic measures to minimize the severity of dAEs and the importance of adherence to the treatment regimen.
AB - Dermatologic adverse events (dAEs) are common with the use of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. First- and second-generation agents (erlotinib, gefitinib, and afatinib) are frequently associated with acneiform rash, pruritus, xerosis, and paronychia; the incidence and characterization of these dAEs have been well described. However, there is evidence that the dAE profile is different with third-generation EGFR-TKIs. Herein, we describe the dAEs associated with third-generation EGFR-TKIs and our clinical experience with osimertinib, a third-generation EGFR-TKI approved by the U.S. Food and Drug Administration for the treatment of metastatic, EGFR T790M mutation-positive non-small cell lung cancer in patients whose disease has progressed on or after EGFR-TKI therapy. Case summaries of patients from two of our institutions who received osimertinib and were referred to a dermatologist for dAEs are also presented. Overall, the evidence suggests that osimertinib is associated with less severe and less frequent dAEs than first- and second-generation EGFR-TKIs and that therefore a different approach is warranted. Finally, we outline dAE management approaches for osimertinib in the context of those typically employed with first- and second-generation EGFR-TKIs. Implications for Practice: Appropriate prevention and management of dermatologic adverse events (dAEs) associated with the use of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) may help patients to continue therapy and lessen any negative impact on their quality of life. EGFR-TKIs are frequently associated with acneiform rash, pruritus, xerosis, and paronychia; however, dAEs associated with third-generation EGFR-TKIs are lower in frequency and severity. Before therapy, health care providers should discuss the potential osimertinib-associated dAEs and encourage patients to report their dAEs. Patients should also be educated on prophylactic measures to minimize the severity of dAEs and the importance of adherence to the treatment regimen.
KW - Dermatologic adverse events
KW - Epidermal growth factor receptor
KW - Non-small cell lung cancer
KW - T790M
KW - Tyrosine kinase inhibitor
UR - http://www.scopus.com/inward/record.url?scp=85048150759&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048150759&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.2017-0582
DO - 10.1634/theoncologist.2017-0582
M3 - Review article
C2 - 29650685
AN - SCOPUS:85048150759
SN - 1083-7159
VL - 23
SP - 891
EP - 899
JO - Oncologist
JF - Oncologist
IS - 8
ER -
