Cetuximab is an effective option for the treatment of metastatic colorectal cancer in the first and subsequent lines of treatment; among its side effects, acneiform skin rash is one of the major causes of treatment delay, reduction, or interruption, with a negative effect on quality of life. No effective strategy to prevent skin rash induced by epidermal growth factor receptor inhibitors is available; however, encouraging results have come from vitamin K1, phytomenadione, applied as a topical formulation. Available studies have been conducted in heterogeneous populations and are mainly focused on the use of vitamin K1-based cream for the treatment, rather than the prophylaxis, of acneiform rash. PATIENTS AND METHODS: Forty-one consecutive patients from a single center all affected by metastatic colorectal cancer and receiving cetuximab, alone or combined with chemotherapy, applied vitamin K1-based cream to prevent the occurrence of acneiform skin rash. The cream was applied twice a day on the face and trunk from the first day of administration of cetuximab. RESULTS: The application of the cream was well tolerated. No grade 4 rash was reported. The proportion of grade 3 skin rash in the first 8 weeks of treatment in this population was 15%, at the lower limit of values reported in the literature, and the proportion of patients with grade 2 rash was reduced (22.5%). CONCLUSION: This experience confirms available data in a homogeneous population, suggesting a possible benefit of topical vitamin K1 as prophylaxis for cetuximab-induced skin rash in patients with metastatic colorectal cancer.

Pilot clinical trial on the efficacy of prophylactic use of vitamin K 1-based cream (Vigorskin) to prevent cetuximab-induced skin rash in patients with metastatic colorectal cancer

PINTA, Francesco;PONZETTI, AGOSTINO;SPADI, ROSELLA;FANCHINI, Laura;ZANINI, Marcello;MECCA, Caterina;SONETTO, Cristina;CIUFFREDA, LIBERO;
2014

Abstract

Cetuximab is an effective option for the treatment of metastatic colorectal cancer in the first and subsequent lines of treatment; among its side effects, acneiform skin rash is one of the major causes of treatment delay, reduction, or interruption, with a negative effect on quality of life. No effective strategy to prevent skin rash induced by epidermal growth factor receptor inhibitors is available; however, encouraging results have come from vitamin K1, phytomenadione, applied as a topical formulation. Available studies have been conducted in heterogeneous populations and are mainly focused on the use of vitamin K1-based cream for the treatment, rather than the prophylaxis, of acneiform rash. PATIENTS AND METHODS: Forty-one consecutive patients from a single center all affected by metastatic colorectal cancer and receiving cetuximab, alone or combined with chemotherapy, applied vitamin K1-based cream to prevent the occurrence of acneiform skin rash. The cream was applied twice a day on the face and trunk from the first day of administration of cetuximab. RESULTS: The application of the cream was well tolerated. No grade 4 rash was reported. The proportion of grade 3 skin rash in the first 8 weeks of treatment in this population was 15%, at the lower limit of values reported in the literature, and the proportion of patients with grade 2 rash was reduced (22.5%). CONCLUSION: This experience confirms available data in a homogeneous population, suggesting a possible benefit of topical vitamin K1 as prophylaxis for cetuximab-induced skin rash in patients with metastatic colorectal cancer.
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Acneiform rash; Cetuximab plus chemotherapy; Phytomenadione; Prevention; Topical treatment; Administration, Cutaneous; Aged; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Cetuximab; Colorectal Neoplasms; Exanthema; Female; Humans; Male; Neoplasm Metastasis; Pilot Projects; Skin Cream; Vitamin K 1; Oncology; Gastroenterology
Pinta, Francesco; Ponzetti, Agostino; Spadi, Rosella; Fanchini, Laura; Zanini, Marcello; Mecca, Caterina; Sonetto, Cristina; Ciuffreda, Libero; Racca, Patrizia
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/1555746
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