Search

Purpose: The objective of this sub-analysis of the BeCet study (NCT01136005) was to examine health-related quality of life (HRQoL) of patients experiencing dermatological adverse events (AEs) during the first 6 weeks of epidermal growth factor receptor inhibitor (EGFRI) treatment., Methods: Patients (n = 85) treated with EGFRI completed five questionnaires during the first 6 weeks of treatment. 77 patients provided enough data for the sub-analysis. Experienced AEs were reported in the Dermatological Reactions Targeted Therapy-Patients (DERETT-P), a symptom experience diary for patients treated with targeted therapy. The impact of EGFRI-associated dermatological adverse events on HRQoL was examined using four HRQoL questionnaires; the Functional Assessment of Cancer Therapy-EGFRI (FACT-EGFRI-18), the Functional Assessment of Cancer Therapy-General (FACT-G), the 36-Item Short Form Health Survey (SF-36), and the Skindex-16., Results: During the first 6 weeks of EGFRI treatment, physical discomfort was the most significantly affected domain. In the entire study population, xerosis (dry skin) (22.3 %) and pruritus (itchy skin) (16.9 %) were reported as the most impactful AEs. For patients experiencing a papulopustular eruption (acneiform rash) pruritus (24.2 %), xerosis (18.9 %), and papulopustular eruption (6.3 %) were reported as the most impactful AEs. Papulopustular eruption, xerosis, and pruritus all showed a significant negative effect on HRQoL, displayed in FACT-EGFRI-18 scores., Conclusions: In addition to papulopustular eruption, xerosis and pruritus are major EGFRI-associated dermatological AEs with an impact on HRQoL, which warrant more attention in clinical practice and research.

Purpose: Dermatologic toxicities from epidermal growth factor receptor inhibitors (EGFRIs) are common, disrupt health-related quality of life (HRQL), and lead to dose reduction or discontinuation of potentially life-saving cancer therapy. The Functional Assessment of Cancer Therapy (FACT)-EGFRI was developed to measure HRQL among patients receiving EGFRIs., Methods: The FACT-EGFRI was developed through the triangulation approach using the established functional assessment of chronic illness therapy method of patient questionnaire construction. This included literature review, qualitative data collection and analysis, and quantitative survey data collection on candidate items to identify the most important items related to EGFRI-induced dermatologic toxicities according to patients receiving EGFRIs and expert clinicians., Results: Twelve expert clinicians and 20 patients were interviewed for the initial questionnaire development. Dermatologic symptoms associated with epidermal growth factor receptor inhibitors endorsed as high priority by both patients and oncologist experts were selected. The final version includes 18 items which assess the physical, emotional, social, and functional impact that skin, nail, and hair toxicities have on patients' HRQL., Conclusions: The FACT-EGFRI-18 measures the severity of patient-reported EGFRI-induced dermatologic toxicities and effects on HRQL and was developed using qualitative data from patients and expert clinicians. Further validation is underway. The FACT-EGFRI-18 may be useful for clinicians and researchers to quantify dermatologic toxicities from the patient perspective in standard clinical care, evaluate the effectiveness of interventions to prevent or reduce dermatologic toxicities, and to guide treatment decision making.

Goals of Work: Advanced colorectal cancer (CRC) has recently been treated with monoclonal antibodies, such as cetuximab. Skin toxicity is a peculiar side effect of cetuximab that may induce patients to interrupt therapy if it becomes serious. This study investigates the psychological and social sequelae of skin rash., Materials and Methods: Patients affected by advanced CRC and treated with cetuximab-based therapy entered the trial. The following questionnaires were used: the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) to measure quality of life (QoL) and the Psychological Distress Inventory (PDI). A single item regarding social avoidance was added with a three-point Likert scale. Toxicity was assessed using the National Cancer Institute Criteria (NCI-2)., Main Results: Eighty patients were recruited; 41% presented psychological distress. As regards social avoidance, 53% of patients answered that they did not avoid going out at all. The rest of the sample answered that they "very much" (22%) or "somewhat" (25%) avoided going out. Psychological distress and social avoidance were not correlated to skin rash, but only to QoL., Conclusion: Skin rash was not found to impact patients' psychological status or social life. Two likely explanations for this finding were that (a) patients with advanced cancer consider skin rash as a part of the complex suffering caused by cancer and (b) patients are encouraged by oncologists to continue treatment because skin rash is indicative of response to therapy. This expectation brings hope and helps patients bear the drug-related side effects.