Management of EGFR Inhibitor-induced Skin Toxicity and Factors Impacting Patients’ Adherence to Skin Toxicity Treatment: Health Care Provider and Patient Surveys in European Oncology Centers

• Published in: Clinical colorectal cancer 2020-06, Vol.19 (2), p.100-108.e9
• Main Authors: Kafatos, George, Dube, Sabada, Burdon, Peter, Demonty, Gaston, Flinois, Alain, Leclerc, Marjorie, Lowe, Kimberly, Feudjo-Tepie, Maurille, Segaert, Siegfried
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cancer Care Facilities - statistics & numerical data; Colorectal Neoplasms - drug therapy; Dermatologic Agents - therapeutic use; Drug Eruptions - diagnosis; Drug Eruptions - drug therapy; Drug Eruptions - epidemiology; Drug Eruptions - etiology; Drug Prescriptions - statistics & numerical data; Epidermal growth factor receptor inhibitor; ErbB Receptors - antagonists & inhibitors; Female; France - epidemiology; Germany - epidemiology; Humans; Incidence; Male; Medication Adherence - statistics & numerical data; Middle Aged; Nurses - statistics & numerical data; Oncologists - statistics & numerical data; Prophylaxis; Protein Kinase Inhibitors - adverse effects; Quality of Life; Rash; Severity of Illness Index; Spain - epidemiology; Surveys and Questionnaires - statistics & numerical data; Treatment discontinuation
• ISSN: 1533-0028; 1938-0674
• DOI: 10.1016/j.clcc.2020.01.001

This study aimed to provide a description of existing measures for the prevention and management of epidermal growth factor receptor inhibitor monoclonal antibody-induced skin toxicities and factors impacting patients’ adherence to those measures in France, Germany, and Spain. The study consisted of 2 separate surveys. Health care professionals (HCPs; oncologists and nurses) in France, Germany, and Spain were interviewed, and patients with metastatic colorectal cancer and head-and-neck cancer in France and Germany self-completed questionnaires. The study was conducted between February and July 2018. A total of 53 oncologists, 44 nurses, and 143 patients participated in the study. HCPs stated that skin toxicities moderately (52%) or severely (28%) impacted patient care. Ninety percent of HCPs reported routine provision of prophylactic measures. The great majority of patients self-reported adherence with the prophylactic (80% to 88% depending on the type of measures) and reactive (93% to drug prescription) skin toxicity recommendations. HCPs estimated patient adherence to be 45% for full adherence and 40% for partial adherence. Most HCPs reported a positive or very positive impact of preventive measures and recommendations on skin toxicity incidence and severity, patients' quality of life, and various aspects of quality of anti-cancer treatment. Skin toxicities are an important adversity negatively impacting on patient care. However, despite the positive perception of the effectiveness of skin toxicity prophylaxis, almost one-third of oncology centers did not provide formal guidelines, and 10% of HCPs did not provide routine prophylactic measures. Patient adherence appears to be high for epidermal growth factor receptor inhibitor monoclonal antibody-induced skin toxicity prevention measures. Certain drugs used to treat metastatic colorectal cancer may induce skin toxicities. Doctors, nurses, and patients were interviewed to understand how skin toxicities are managed within oncology centers in Europe. About one-third of centers did not provide formal guidelines, but patients’ adherence to recommended measures such as patient education and the prescription of skin ointments appears to be high.