Cutaneous adverse effects with HER1/EGFR-targeted agents:: Is there a silver lining?
Cutaneous adverse effects with HER1/EGFR-targeted agents:: Is there a silver lining?
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DOI：
10.1200/jco.2005.00.6916
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发表时间：
2005-08-01
影响因子：
45.3
通讯作者：
Saltz, L
中科院分区：
文献类型：
--
作者：
Peréz-Soler, R;Saltz, L
人表皮生长因子受体（HER 1/EGFR）在许多实体瘤中失调，使其成为抗癌治疗的有吸引力的靶点。靶向该受体的许多药剂正在使用或开发中。该类药物常见的特定不良反应是丘疹脓疱性皮疹，通常发生在面部和上躯干，通常以剂量依赖性方式发生。关于这种皮疹的病因学知之甚少，也没有明确的循证管理建议。组织学数据表明皮疹可能是由皮肤中的HER 1/EGFR抑制引起的，尽管这尚未得到证实。研究结果表明，皮疹的发生与反应和/或生存之间存在关系，使皮疹成为潜在的活动替代标志物。来自多项西妥昔单抗和厄洛替尼研究的数据显示皮疹和应答之间以及皮疹和生存之间存在一致的关系。目前吉非替尼的皮疹和临床结局之间的关系不太一致。一些研究报告了相关性，而另一些则没有。皮疹和临床获益之间可能相关的原因目前尚不清楚，需要进行额外的研究来确定这一观察结果的临床效用。
The human epidermal growth factor receptor (HER1/EGFR) is dysregulated in many solid tumors, making it an attractive target for anticancer therapy. A number of agents that target this receptor are in use or in development. A specific adverse effect common to this class of agent is a papulopustular rash, usually on the face and upper torso, which generally occurs in a dose-dependent manner. Little is known about the etiology of this rash, and there are no clear evidence-based management recommendations. Histologic data indicate that rash may be caused by HER1/EGFR inhibition in skin, although this has not been confirmed. Findings suggest that there is a relationship between the development of rash and response and/or survival, making rash a potential surrogate marker of activity. Data from multiple studies with cetuximab and erlotinib show a consistent relationship between rash and response, as well as between rash and survival. The relationship between rash and clinical outcome is currently less consistent for gefitinib. Some studies report a correlation, whereas others do not. The cause of the possible relationship between rash and clinical benefit remains unclear at this time, and additional studies are needed to determine the clinical utility of this observation.