Systemic doxycycline for pre-emptive treatment of anti-EGFR-related skin toxicity in patients with metastatic colorectal cancer receiving first-line panitumumab-based therapy: a post hoc analysis of the Valentino study.

Autor: Raimondi A; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy., Corallo S; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy., Lonardi S; Medical Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto-IRCCS, Padua, Italy., Antoniotti C; Unit of Medical Oncology, Department of Translational Research and New Technologies in Medicine, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy., Rimassa L; Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy.; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy., Amatu A; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy., Tampellini M; Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Orbassano, Italy., Racca P; Colorectal Cancer Unit, Medical Oncology Division 1, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Turin, Italy., Murialdo R; Department of Internal Medicine, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy., Clavarezza M; Medical Oncology Unit, Ente Ospedaliero Ospedali Galliera, Genoa, Italy., Zaniboni A; Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy., Toscano G; Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Messina, Italy., Tomasello G; Medical Oncology Unit, ASST Ospedale di Cremona, Cremona, Italy., Petrelli F; Medical Oncology Unit, Oncology Department, ASST Bergamo Ovest, Treviglio, Italy., Antonuzzo L; Clinical Oncology Unit, AOU Careggi, Florence, Italy.; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Giordano M; Medical Oncology Unit, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy., Cinieri S; Medical Oncology Unit, Ospedale Antonio Perrino, Brindisi, Italy., Longarini R; Medical Oncology Unit, Azienda Ospedaliera San Gerardo, Monza, Italy., Niger M; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy., Antista M; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy., Ambrosini M; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy., Pagani F; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy., Prisciandaro M; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy.; Oncology and Hemato-oncology Department, University of Milan, via Festa del Perdono 7, 20122, Milan, Italy., Randon G; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy., de Braud F; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy.; Oncology and Hemato-oncology Department, University of Milan, via Festa del Perdono 7, 20122, Milan, Italy., Di Bartolomeo M; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy., Pietrantonio F; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy. filippo.pietrantonio@istitutotumori.mi.it.; Oncology and Hemato-oncology Department, University of Milan, via Festa del Perdono 7, 20122, Milan, Italy. filippo.pietrantonio@istitutotumori.mi.it., Morano F; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2021 Jul; Vol. 29 (7), pp. 3971-3980. Date of Electronic Publication: 2021 Jan 03.
DOI: 10.1007/s00520-020-05972-2
Abstrakt: Introduction: The combination of anti-EGFRs and doublet chemotherapy is considered the optimal upfront option for patients with RAS/BRAF wild-type left-sided metastatic colorectal cancer (mCRC). The prophylactic or reactive treatment with tetracyclines for EGFR inhibitor-induced skin toxicity is currently clinical practice, though non-conclusive results are available.
Methods: We performed a post hoc analysis of the Valentino study that randomized RAS wild-type mCRC patients to two panitumumab-based maintenance regimens after the first-line induction, aimed at assessing the safety and efficacy of the administration of a pre-emptive doxycycline prophylaxis for anti-EGFR-related skin toxicity. We assessed the rate of treatment-related and panitumumab-related adverse events (AEs), treatment intensity, progression-free survival (PFS), and overall survival (OS).
Results: A total of 226 patients, out of the 229 enrolled in the Valentino study, were eligible for the analysis. Overall, 143 (63%) and 83 (37%) patients received or not the antibiotic prophylaxis for skin toxicity. Any grade and G3/4 panitumumab-related AEs were reported in 89% versus 92% (p = 0.650) and 27% versus 27% (p = 1.000) patients who received or not the pre-emptive prophylaxis, respectively. Any grade and G3/4 skin rash occurred in 81% versus 90% (p = 0.085) and 27% versus 25% (p = 0.876) patients receiving or not the prophylaxis, respectively. No significant differences in terms of treatment duration, treatment delays or dose reductions, PFS, and OS were observed in the two sub-populations.
Conclusion: The adequate management of anti-EGFR-related skin toxicity is fundamental to optimize the outcome of mCRC patients, balancing the survival benefit with patients' quality of life, especially in the first-line setting.
Databáze: MEDLINE
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