表皮生长因子受体拮抗剂相关皮肤不良反应表现及治疗进展

Manifestation and therapies of EGFRI-induced dermatological toxicities

  • 摘要: 近十几年来,除了手术、化疗、放疗三项常规治疗手段之外,分子靶向药物使肿瘤治疗有了重大突破。分子靶向药物治疗作为一种新型治疗手段,正在肿瘤内科治疗领域发挥越来越重要的作用。其中,表皮生长因子受体拮抗剂(epidermal growth factor receptor inhibitors,EGFRIs)是目前临床应用最为广泛的一类分子靶向药物。EGFRIs的主要不良反应为皮肤不良反应、腹泻、乏力、间质性肺炎等。皮肤不良反应是EGFRIs最常见的不良反应,经常会影响患者生存质量,导致药物减量或停药。其主要表现为痤疮样皮疹甚至脓疱样丘疹、皮肤瘙痒、皮肤干燥、甲沟炎及甲裂、毛发改变及超敏反应。目前,临床上标准治疗方案包括抗生素、糖皮质激素、抗组胺药等,但是疗效并不满意。本文旨在对EGFRIs相关皮肤不良反应表现及治疗进展进行综述,以期为临床提供参考。

     

    Abstract: In the past decades, the advent of molecular targeted agents has been a considerable breakthrough for cancer patients, except for traditional operation, chemotherapy, and radiotherapy. As a novel therapeutic method, molecular targeting treatment is important in the field of medical oncology, in which epidermal growth factor receptor inhibitors (EGFRIs) have been widely used as targeted agents. Dermatological toxicities are the common side effects associated with the EGFRIs. Diarrhea, weakness, and pneumonia can be observed. EGFRI-induced dermatological toxicities may disrupt the health-related quality of life and cause anticancer treatment dose adjustments or discontinuance. The dermatological toxicities mainly involve rash acneiform, pruritus, xerosis, paronychia, hair change, and skin hypersensitivity. Treatment recommendations from guidelines include antibiotics, corticosteroids, and antihistamines, but their clinical therapeutic efficacy have not been proven. Therefore, oncologists and dermatologists are investigating effective medication. This article reviews the advances in the study of the clinical manifestations and drug therapies of EGFRI-induced dermatological toxicities to provide reference for clinical practitioners.

     

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