Cutaneous Reactions to Anti EGF Drugs and Management (For professionals)

• Examples of Anti-EGF drugs:

1. Cetuximab (e.g. Erbitux): used in the treatment of Colorectal cancer.
2. Gefitinib (e.g. Iressa): used in the treatment of Lung Cancer
3. Erlotinib (e.g Tarceva): used in the treatment of small-cell Lung cancer, Pancreatic cancers and other cancers

What is a typical reaction ?

• It is a reaction consisting of papules and pustules distributed on seborrheic areas (seborrhoeic)

Classification of Reactions (depends on the extent) and management

• Type 1: papules located on the face = continue the chemotherapy and apply a topical antibiotic (e.g. Dalacin) on the lesions
• Type 2: papulopustules also limited on the face = continue the chemotherapy and apply a topical antibiotic (e.g. Dalacin) on the lesions
• Type 3: papulopustules extending on the trunk and occupying less than 20% of the Body Surface Area (BSA) = stop the chemotherapy for 2 weeks, treat with 0.5mg/Kg/d of Prednisone for 5 to 7 days, treat with topical antiinflammatory drugs and a topical antibiotic. The chemotherapy may be started 2 weeks later at a reduced dose or on alternate days.
• Type 4: papulopustules and ulcerations extending on the trunk and occupying more than 30% of the Body Surface Area (BSA) = stop the chemotherapy for 2 weeks, treat with 0.5mg/Kg/d of Prednisone for 5 to 7 days, treat with topical antiinflammatory drugs and a topical antibiotic. The chemotherapy may be started 2 weeks later at a reduced dose or on alternate days.

Source: Derrick Aw. Adverse Cutaneous Reactions to Newer Cancer Drugs and Management Principles

Source of information: here