Epidermal Growth Factor Receptor Plus Radiation Raises Risk of Dermatologic Toxicity

NEW YORK, April 23, 2009 — Pooled data from studies involving numerous patients show that although the addition of epidermal growth factor receptor (EGFR) inhibitors to radiotherapy has improved action against solid tumors, it has also increased radiation dermatitis.

"Whereas the pivotal study of cetuximab combined with radiotherapy against head and neck cancer did not show any greater skin toxicity," senior investigator Dr Mario E. Lacouture told Reuters Health, "our meta-analysis of large patient groups suggests that there is a greater risk of severe skin and mucosal side effects when an EGFR inhibitor is administered concurrently with radiation.

"These findings underscore the need for better prophylactic and management strategies for patients receiving these combined regimens," he added.

Dr Lacouture of Northwestern University in Chicago, et al analyzed reports of radiation dermatitis, rash, and mucositis from 24 phase 1, 2, and 3 trials involving 933 patients. Randomized trials of radiotherapy and chemoradiation were used as controls.

According to their article in the March 15 issue of Cancer, the EGFR inhibitor combination regimen gave a risk ratio for radiation dermatitis of 2.38 compared with radiotherapy alone. The risk ratio for rash was 3.01, and for mucositis it was 1.76, suggesting an enhanced risk of dermatologic toxicities.

"With increasing use of EGFR inhibitors plus radiation, greater skin side effects are important not only because they affect quality of life, but they may also impact consistent administration of therapy, affecting cancer control and patient survival," concluded Dr Lacouture.

Source: Reuters Health Information