1
|
Ugurel S, Pföhler C, Gutzmer R. [Cutaneous adverse events to systemic anticancer therapies : Hand-foot syndrome and nail changes]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:451-458. [PMID: 38802652 DOI: 10.1007/s00105-024-05351-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Hand-foot syndrome (HFS) and nail changes are frequent adverse events of anticancer therapies. OBJECTIVES To provide a review of current evidence in HFS and nail disorders associated with medical tumor treatment. MATERIALS AND METHODS Basis is the current German S3 guideline "Supportive therapy in oncologic patients" and literature on this topic published since the guideline was finalized. RESULTS Two variants of HFS are distinguished: a chemotherapy-associated and a kinase-inhibitor-associated variant. In the first form, painful erythema, blisters and ulceration can occur, also in other areas with a high number of sweat glands such as axillary and inguinal regions. Thus, the secretion of toxic substances through sweat glands is a proposed pathogenetic mechanism. For the second form, which results in callus-like painful thickening of the horny layer on areas of mechanic pressure, a vascular mechanism is proposed. For prophylaxis of HFS, avoidance of mechanical stress, regular cleaning of predisposed areas, and also urea- and diclofenac-containing ointments are recommended; in case of infusions (taxanes, doxorubicine), cooling of hands and feet during infusion is recommended. In case of manifest HFS, dose reduction or prolongation of intervals of the associated treatment are recommended. Nail changes often develop under therapy with chemotherapeutic agents but also under treatment with agents such as checkpoint inhibitors or under targeted therapy. Different components of the nail unit may be involved such as the nail matrix, nail bed, nail plate, hyponychium, lunula and proximal and lateral nail folds. CONCLUSION This work gives insight into the pathophysiology of HFS and nail disorders that develop under systemic oncologic treatments and gives recommendations for prophylaxis and treatment.
Collapse
Affiliation(s)
- Selma Ugurel
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, 45122, Essen, Deutschland
| | - Claudia Pföhler
- Klinik für Dermatologie, Venerologie und Allergologie, Univ.-Klinikum des Saarlandes, 66421, Homburg/Saar, Deutschland.
| | - Ralf Gutzmer
- Universitäts-Klinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Johannes Wesling Klinikum Minden, Minden, Deutschland, 32427
| |
Collapse
|
2
|
Mittal S, Khunger N, Kataria SP. Nail Changes With Chemotherapeutic Agents and Targeted Therapies. Indian Dermatol Online J 2022; 13:13-22. [PMID: 35198463 PMCID: PMC8809183 DOI: 10.4103/idoj.idoj_801_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 05/15/2021] [Accepted: 11/27/2021] [Indexed: 11/08/2022] Open
Abstract
Patients on Cancer chemotherapeutic agents often develop nail changes most of which are only cosmetic concern and disappear on drug withdrawal. But some nail changes can be painful and disabling thereby affecting quality of life substantially. Different components of the nail unit include the nail matrix, nail bed, nail plate, the hyponychium, lunula, the proximal and lateral nail folds. In this article we review the nail changes induced by chemotherapeutics and targeted anticancer drugs, preventive measures and treatment options available.
Collapse
Affiliation(s)
- Shankila Mittal
- Department of Dermatology, Safdarjung Hospital, New Delhi, India
| | - Niti Khunger
- Department of Dermatology, Safdarjung Hospital, New Delhi, India
| | - Satya Pal Kataria
- Department of Medical Oncology, Safdarjung Hospital, New Delhi, India
| |
Collapse
|
3
|
Ben Nasr S, Zribi A, Ben Hassen M, Doghri Y, Ben Abdallah I, Trigui E, Fendri S, Ayari J, Balti M, Haddaoui A. Toxicity profile of taxanes in Tunisian cancer patients: A retrospective study of 90 cases. Bull Cancer 2021; 108:266-271. [PMID: 33423777 DOI: 10.1016/j.bulcan.2020.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/26/2020] [Accepted: 10/08/2020] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Taxanes are widely used in medical oncology. The aim of our study was to report and analyze the toxicity features of these drugs in Tunisian patients and to determine their impact on treatment response. METHODS Our retrospective study concerned 90 patients treated by taxanes in a medical oncology unit, from January 2014 to January 2017. We collected their epidemiologic and anatomo-clinical data and we detailed toxicity features including types grades and impact on tumor response. RESULTS Median age was 46 years. 80% of patients had breast cancer. Tumors were metastatic in 23.3% of cases. Nail toxicity was observed in 100% of patients. Grade I-II digestive toxicity was observed in 54.4% of cases. Hematological toxicity was noted in 42.2% of patients and it reached grade III-IV in five patients. Neurological toxicity occurred in 31% of patients and was grade III-IV in 6 cases. Alopecia was observed in 60% of patients. Fatigue was noted in 57.8% of patients. Myalgia was observed in 42.2% of patients. Toxicity did not affect the response to treatment. CONCLUSION The taxanes' toxicity profile in Tunisian patients is characterized by more frequent digestive and nail toxicities and less frequent hematological toxicities, dose reduction and treatment delays than other populations.
Collapse
Affiliation(s)
- Sonia Ben Nasr
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007 Tunis, Tunisia; The military hospital of Tunis, Department of medical oncology, Montfleury 1008, Tunisia.
| | - Aref Zribi
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007 Tunis, Tunisia; The military hospital of Tunis, Department of medical oncology, Montfleury 1008, Tunisia
| | - Mouna Ben Hassen
- Université de Tunis El Manar, Faculté des sciences de Tunis, 2092 Tunis, Tunisia
| | - Yosr Doghri
- Université de Tunis El Manar, Faculté des sciences de Tunis, 2092 Tunis, Tunisia
| | - Ichrak Ben Abdallah
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007 Tunis, Tunisia; The military hospital of Tunis, Department of medical oncology, Montfleury 1008, Tunisia
| | - Emna Trigui
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007 Tunis, Tunisia; The military hospital of Tunis, Department of medical oncology, Montfleury 1008, Tunisia
| | - Sana Fendri
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007 Tunis, Tunisia; The military hospital of Tunis, Department of medical oncology, Montfleury 1008, Tunisia
| | - Jihen Ayari
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007 Tunis, Tunisia; The military hospital of Tunis, Department of medical oncology, Montfleury 1008, Tunisia
| | - Mehdi Balti
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007 Tunis, Tunisia; The military hospital of Tunis, Department of medical oncology, Montfleury 1008, Tunisia
| | - Abderrazek Haddaoui
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007 Tunis, Tunisia; The military hospital of Tunis, Department of medical oncology, Montfleury 1008, Tunisia
| |
Collapse
|
4
|
Alizadeh N, Mirpour SH, Darjani A, Rafiei R, Rafiei E, Mohammadhoseini M. Dermatologic adverse effects of breast cancer chemotherapy: a longitudinal prospective observational study with a review of literature. Int J Dermatol 2020; 59:822-828. [PMID: 32406107 DOI: 10.1111/ijd.14916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 01/31/2020] [Accepted: 04/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Breast cancer patients may experience an increased chance of survival with adjuvant chemotherapy. However dermatologic adverse effects can cause major discomfort due to physical or cosmetic problems. This study aims to describe dermatologic complications in breast cancer patients during chemotherapy. METHODS This longitudinal prospective observational study included data on women with non-metastatic breast cancer whom were treated with AC-T protocol (anthracycline, cyclophosphamide, and taxane) adjuvant chemotherapy and consecutively enrolled during two years. The study was performed in an educational and tertiary referral center. The patients' information including age, body mass index (BMI), past medical history, and different dermatologic complications were collected for all participants. RESULTS Of 190 enrolled women, all patients experienced alopecia, which occurred in 131 patients (68.9%) after the first cycle. Skin, mucosal, and nail involvement were respectively seen in 46 (24.2%), 51 (26.8%), and 86 (45.2%) cases. Cutaneous complications were observed mainly between the third and sixth chemotherapy cycles. Palmoplantar erythema and palmoplantar dysesthesia were the most common cutaneous complications. Dermatologic adverse effects were significantly more frequent in the patients with an underlying disease. CONCLUSION These findings suggest that dermatologic adverse effects of adjuvant chemotherapy are common and could be induced by all components of AC-T regimen. These complications should be skillfully managed to increase patients' comfort.
Collapse
Affiliation(s)
- Narges Alizadeh
- Skin Research Center, Department of Dermatology, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyyed Hossein Mirpour
- Department of Hematology and Oncology, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Abbas Darjani
- Skin Research Center, Department of Dermatology, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Rana Rafiei
- Skin Research Center, Department of Dermatology, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Rafiei
- Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran
| | - Maryam Mohammadhoseini
- Skin Research Center, Department of Dermatology, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
5
|
Hegde S, Mizaj Z, Bhat G, Amin V, Pinto M, Shenoy M. Nail manifestations in cancer chemotherapy: A cross-sectional study. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2020. [DOI: 10.4103/jdds.jdds_79_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
6
|
Skin Care During and After Radiotherapy and Anticancer Treatment. Radiat Oncol 2020. [DOI: 10.1007/978-3-319-52619-5_115-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
7
|
Ferreira MN, Ramseier JY, Leventhal JS. Dermatologic conditions in women receiving systemic cancer therapy. Int J Womens Dermatol 2019; 5:285-307. [PMID: 31909148 PMCID: PMC6938835 DOI: 10.1016/j.ijwd.2019.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/12/2019] [Accepted: 10/13/2019] [Indexed: 12/24/2022] Open
Abstract
As advances in cancer therapies have improved cancer-related survival, novel therapeutics have also introduced a variety of dermatologic toxicities, and an increased number of patients are living with these sequalae. Women with cancer in particular experience a spectrum of dermatologic conditions that affect their skin, hair, nail, and mucosal surfaces. Studies have shown that these toxic effects can significantly affect quality of life and alter a woman's self-image, cultural identity, femininity, sexuality, and mental health. In severe instances, dermatologic toxicities may even disrupt cancer therapy and can therefore affect overall survival and treatment response. In this article, we review the dermatologic adverse effects from traditional chemotherapy, targeted therapy, immune checkpoint inhibitors, and endocrine therapy that disproportionately affect women. The timely diagnosis and management of these dermatologic conditions is crucial in the multidisciplinary care of women with cancer.
Collapse
|
8
|
Naveed S, Thappa DM, Dubashi B, Pandjatcharam J, Munisamy M, Singh N. Mucocutaneous Adverse Reactions of Cancer Chemotherapy and Chemoradiation. Indian J Dermatol 2019; 64:122-128. [PMID: 30983608 PMCID: PMC6440193 DOI: 10.4103/ijd.ijd_129_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: With the introduction of newer anti-cancer agents, the adverse effects have become more rampant which call for concern in the treatment of patients with cancer. Hence, the assessment and management of dermatological adverse effects of anti-cancer therapy have become a significant part of the care of patients with cancer and require proper and close collaboration between the dermatologists and the oncologists. Aims: To assess the frequency and pattern of mucocutaneous adverse reactions to cancer chemotherapy and chemoradiation and grade them according to their severity and to identify hematological and biochemical changes related to cancer chemotherapy-induced mucocutaneous adverse reactions. Materials and Methods: This was a descriptive study done among 226 patients in an Indian tertiary care hospital, who presented with mucocutaneous adverse reactions to either chemotherapy alone or combination of chemotherapy and radiation to dermatology, medical oncology and radiotherapy outpatient departments. Detailed history and examination were undertaken. Visual analog score (VAS) was employed to quantify pain and pruritus. Correlation of various biochemical and hematological parameters with chemotherapy-induced adverse reactions was attempted and grading of adverse reactions was done based on the severity scale of Common Terminology Criteria for Adverse Events (CTCAE). Results: The common cutaneous adverse reactions observed in our study were nail changes (194 patients; 85.84%), followed by skin changes (191; 84.51%), hair changes (159, 70.35%), mucosal changes (34, 15.04%), and other miscellaneous manifestations. Grade 1 manifestations comprised of 49.91% of total manifestations followed by Grade 2 (45.45%) and Grade 3 (5.64%). In addition to bleomycin, other chemotherapeutic agents also had been shown to produce flagellate dermatitis in our study. Conclusion: Nail changes, skin changes, hair changes and mucosal changes occurred frequently as a significant side effect of chemotherapy, which a physician should be aware of, while selecting a chemotherapeutic drug.
Collapse
Affiliation(s)
- Sheikh Naveed
- Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Devinder Mohan Thappa
- Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Biswajit Dubashi
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jagadeesan Pandjatcharam
- Department of Radiotherapy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Malathi Munisamy
- Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Nidhi Singh
- Department of Dermatology, Global Health City, Chennai, Tamil Nadu, India
| |
Collapse
|
9
|
Salzmann M, Marmé F, Hassel JC. Prophylaxis and Management of Skin Toxicities. Breast Care (Basel) 2019; 14:72-77. [PMID: 31798377 DOI: 10.1159/000497232] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Skin toxicity is a common problem not only when treating breast cancer but in all cancer types. Visible on the surface, these side effects come not just with burdening symptoms but also with stigmatization. With increasing diversity in therapeutic options, dermatologic side effects are also becoming increasingly complex and more challenging for the clinician. We reviewed the most common dermatologic side effects of current anticancer therapy, including toxicity induced by chemotherapy, targeted therapy, and immunotherapy. In particular, we focus on xerosis and pruritus, (acneiform) exanthema, hand-foot syndrome, nail toxicities, alopecia, and mucositis. We propose measures for the prevention and management of these side effects based on current literature. With high incidences in both chemotherapy and targeted therapy, prophylactic measures are crucial to reducing the incidence and severity of skin toxicity and therefore key to therapy adherence. Appropriate management of these toxicities will help avoid unnecessary treatment discontinuation.
Collapse
Affiliation(s)
- Martin Salzmann
- National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg.,Department of Dermatology, University Hospital Heidelberg, Heidelberg
| | - Frederik Marmé
- National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg.,Department of Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Jessica C Hassel
- National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg.,Department of Dermatology, University Hospital Heidelberg, Heidelberg
| |
Collapse
|
10
|
Polymeric nanoparticle-docetaxel for the treatment of advanced solid tumors: phase I clinical trial and preclinical data from an orthotopic pancreatic cancer model. Oncotarget 2018; 7:77348-77357. [PMID: 27764799 PMCID: PMC5363590 DOI: 10.18632/oncotarget.12668] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 09/25/2016] [Indexed: 11/25/2022] Open
Abstract
We assessed the efficacy of the polymeric nanoparticle containing docetaxel (PNP-DTX) in preclinical mouse models and determined the maximum tolerated dose (MTD) through clinical study. Subcutaneous and orthotopic mouse models were dedicated. Tumor growth delay in orthotopic model and quantification of in vivo imaging in orthotopic model were evaluated. Phase I clinical study was a single-center, prospective, open-label trial in advanced solid tumors. PNP-DTX was injected intravenously and the starting dose was 20 mg/m2 escalated to 35 mg/m2, 45 mg/m2, 60 mg/m2 and 75 mg/m2. Pharmacokinetics, tumor response, toxicities were evaluated. Preclinical result revealed the more potent cytotoxic effect of PNP-DTX than docetaxel (DTX). However, there was no difference between PNP-DTX and DTX in subcutaneous model. Tubulin polymerization assay showed that PNP-DTX preserved original mode of action of DTX. For phase I clinical trial, 18 patients were analyzed. The dose of 75 mg/m2 was tentatively determined as the MTD and the most common toxicity was grade 4 neutropenia not lasting over 7days. The Cmax of 60 mg/m2 PNP-DTX and AUClast of 45 mg/m2 PNP-DTX were measured to be comparable to those of 75 mg/m2 DTX. Partial remission (PR) was achieved in 4 (22%) patients. The potency of PNP-DTX was revealed especially in orthotopic mouse model. The MTD of PNP-DTX could not be confirmed, but 75 mg/m2 was tentatively determined. The PNP-DTX of 45 mg/m2 had the same pharmacokinetic profile with that of 75 mg/m2 DTX.
Collapse
|
11
|
Chu NS, Wu IC, Chen LT, Chin YY. Beau's lines in nails: An indicator of recent Docetaxel and 5-FU use. Kaohsiung J Med Sci 2018; 34:181-183. [PMID: 29475467 DOI: 10.1016/j.kjms.2017.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 10/18/2022] Open
Affiliation(s)
- Neng-Sheng Chu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - I-Chen Wu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Li-Tzong Chen
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Yi-Ying Chin
- Department of Dermatology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
12
|
Takahata H, Tanabe K, Takaki A, Yamanouchi T, Mimura Y, Nitta A, Yasuda H, Kashii T, Adachi I. A novel predictive factor for the onset time of docetaxel-induced onychopathy: a multicenter retrospective study. J Pharm Health Care Sci 2016; 2:24. [PMID: 27708837 PMCID: PMC5041292 DOI: 10.1186/s40780-016-0057-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 09/14/2016] [Indexed: 11/24/2022] Open
Abstract
Background Taxanes are known to cause onychopathy. Previous studies have reported the relationship between onychopathy and paclitaxel dosing intervals and cumulative doses. However, there are no studies of the predictive factors for docetaxel-induced nail changes. The present study used the drug accumulation rate (mg/m2/day) as a novel indicator and evaluated its usefulness for the prediction of onychopathy. Methods From January 2008 to December 2009, we examined patients who received docetaxel at the Toyama University Hospital and Tonami General Hospital to determine the time to onset of onychopathy, the accumulation rate, and the cumulative dose. We then divided the study subjects into two groups, and used Receiver Operating Characteristic (ROC) analysis to calculate a cut-off value. We evaluated both indicators as predictive factors for onychopathy using the log-rank test and Cox proportional hazards model. Results Ninety-five patients were included in the present study. The results of the log-rank test sub-analysis revealed that the median number of days until onychopathy onset was significantly shorter in patients with an accumulation rate greater than the cut-off (P = 0.009), and in those with a cumulative dose below the cut-off (P < 0.001). The hazard ratios for the accumulation rate and cumulative dose, evaluated using Cox proportional hazards regression analysis, were 1.44 (P = 0.036) and 0.99 (P < 0.001), respectively. Conclusions The results of the present study indicated that the drug accumulation rate influenced the time to onset of docetaxel-induced onychopathy. Trial registration This study is not applicable for trial registration due to retrospective chart review without intervention.
Collapse
|
13
|
Kenmotsu H, Tanigawara Y. Pharmacokinetics, dynamics and toxicity of docetaxel: Why the Japanese dose differs from the Western dose. Cancer Sci 2015; 106:497-504. [PMID: 25728850 PMCID: PMC4452149 DOI: 10.1111/cas.12647] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 02/18/2015] [Accepted: 02/21/2015] [Indexed: 02/01/2023] Open
Abstract
Docetaxel (Taxotere®) has been one of the most important chemotherapeutic drugs for cancer treatment since 1996. Although a large number of clinical studies have been conducted in various cancer fields, there is a discrepancy in the standard dose between Japan and Western countries. This article reviews the pharmacokinetic, pharmacodynamic and toxicological profiles of docetaxel, and explains why there exists an ethnic difference in dose, and further discusses which direction we should go forward to solve this problem. The original recommended dose was 100 mg/m2 every 3 weeks in US and European populations, while a Japanese phase I study suggested the recommended dose as 60 mg/m2 every 3 weeks. A prospective population pharmacokinetic analysis of docetaxel conducted in both the USA/Europe and Japan, indicated an absence of ethnic difference in the pharmacokinetics. Both analyses demonstrated that docetaxel clearance is related to α1-acid glycoprotein level, hepatic function, age and body surface area. The relationship was observed between increasing docetaxel dose and increased tumor response rates across the dose range of 60 to 100 mg/m2. The area under the serum concentration time curve (AUC) of docetaxel at the first cycle was significantly related to time to progression. Hematological toxicities were well correlated with the AUC of docetaxel, and severe hematological toxicities were more frequently observed in Japanese patients treated with 60 mg/m2, compared to the US/European patients treated with 75–100 mg/m2 dose. The Japanese population seems more susceptible to the toxicity of docetaxel. A docetaxel dose of 75 mg/m2 is now standard not only in global trials but also in recent Japanese trials. Although the optimal dose of docetaxel is still unclear, we need to continue to seek the appropriate dose of docetaxel depending on patient status and the goals of chemotherapy.
Collapse
Affiliation(s)
- Hirotsugu Kenmotsu
- Department of Clinical Pharmacokinetics and Pharmacodynamics, Keio University School of Medicine, Tokyo, Japan.,Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yusuke Tanigawara
- Department of Clinical Pharmacokinetics and Pharmacodynamics, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
14
|
Reddy LH, Bazile D. Drug delivery design for intravenous route with integrated physicochemistry, pharmacokinetics and pharmacodynamics: illustration with the case of taxane therapeutics. Adv Drug Deliv Rev 2014; 71:34-57. [PMID: 24184489 DOI: 10.1016/j.addr.2013.10.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 10/22/2013] [Accepted: 10/24/2013] [Indexed: 12/12/2022]
Abstract
This review is aimed at combining the published data on taxane formulations into a generalized Drug Delivery approach, starting from the physicochemistry and assessing its relationships with the pharmacokinetics, the biodistribution and the pharmacodynamics. Owing to the number and variety of taxane formulation designs, we considered this class of cytotoxic anticancer agents of particular interest to illustrate the concepts attached to this approach. According to the history of taxane development, we propose a classification as (i) "surfactant-based formulations" first generation, (ii) "surfactant-free formulations" second generation and (iii) "modulated pharmacokinetics drug delivery systems" third generation. Since our objective was to make the link between (i) the physicochemistry of the drug and carrier and (ii) the efficacy and safety of the drug in preclinical animal models and (iii) in human, we focused on the drug delivery technologies that were tested in clinic.
Collapse
Affiliation(s)
- L Harivardhan Reddy
- Drug Delivery Technologies and Innovation, Pharmaceutical Sciences Department, Sanofi Research and Development, 13 Quai Jules-Guesde, 94403 Vitry-sur-Seine, France.
| | - Didier Bazile
- Drug Delivery Technologies and Innovation, Pharmaceutical Sciences Department, Sanofi Research and Development, 13 Quai Jules-Guesde, 94403 Vitry-sur-Seine, France
| |
Collapse
|
15
|
Akoglu G. Docetaxel-induced palmoplantar erythrodysesthesia syndrome and long-lasting multiple nail changes. Indian J Pharmacol 2014; 46:225-7. [PMID: 24741199 PMCID: PMC3987196 DOI: 10.4103/0253-7613.129326] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 08/10/2013] [Accepted: 01/12/2014] [Indexed: 01/28/2023] Open
Abstract
Palmoplantar erythrodysesthesia syndrome (PPES) and nail changes are common presentations of cutaneous toxicity of docetaxel chemotherapy, which deteriorate the quality of life of patients. Herein, we describe a female patient who developed PPES and multiple nail changes due to docetaxel treatment for infiltrative ductal carcinoma. Cold application and elevation of extremities during docetaxel infusion, potent topical steroids and oral pyridoxine increased the tolerance to chemotherapy and provided regression of painful cutaneous lesions without cessation of the treatment.
Collapse
Affiliation(s)
- Gulsen Akoglu
- Dermatology Clinic, Ankara Halil Sivgin Cubuk State Hospital, Ankara, Turkey
| |
Collapse
|
16
|
McCarthy AL, Shaban RZ, Gillespie K, Vick J. Cryotherapy for docetaxel-induced hand and nail toxicity: randomised control trial. Support Care Cancer 2013; 22:1375-83. [PMID: 24362908 DOI: 10.1007/s00520-013-2095-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 12/05/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE This study investigated the efficacy and safety of cryotherapy, in the form of frozen gel gloves, in relation to docetaxel-induced hand and fingernail toxicities. PATIENTS AND METHODS After piloting with 21 patients, a consecutive series sample of patients (n=53) prescribed docetaxel every 3 weeks, for a minimum of three cycles, was enrolled in this randomised control trial. Participants acted as their own control, with the frozen gel glove worn on one randomised hand for 15 min prior to infusion, for the duration of the infusion, and for 15 min of after completion of treatment. Hand and nail toxicities were evaluated by two blinded assessors according to CTCAE.v4 criteria. To assess the potential for cross-infection of multi-use gloves, microbial culture and sensitivity swabs were taken of each glove at every tenth use. RESULTS Of the 53 participants enrolled in the main study, 21 provided evaluable data. There was a 60 % withdrawal rate due to patient discomfort with the intervention. The mean incidence and severity of toxicities in all evaluable cycles in control and intervention hands respectively were erythroderma grade 1 (5/5 %), nail discolouration grade 1 (81/67 %), nail loss grade 1 (19/19 %) and nail ridging grade 1 (57/57 %). No significant differences were determined between hand conditions in terms of time to event, nor in terms of toxicity in gloved and non-gloved hands. CONCLUSION While cryotherapy in the form of frozen gloves for the cutaneous toxicities associated with docetaxel is safe, its limited efficacy, patient discomfort and some logistical issues preclude its use in our clinical setting.
Collapse
|
17
|
Kibata K, Tamaki T, Inagaki N, Ogata M, Shimizu T, Nomura S. Nail alterations as a surrogate marker for the efficacy of low-dose metronomic chemotherapy. Oncol Lett 2013; 5:1123-1128. [PMID: 23599750 PMCID: PMC3629050 DOI: 10.3892/ol.2013.1178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 01/31/2013] [Indexed: 12/31/2022] Open
Abstract
Docetaxel is a well-known causative agent of nail alterations. The aim of this study was to reveal the impact of nail alterations associated with low-dose metronomic (LDM) docetaxel chemotherapy on the survival of non-small cell lung cancer (NSCLC) patients. Clinical information, survival data and nail alterations in patients treated with LDM docetaxel chemotherapy (docetaxel 15 mg/m2 per week) were retrospectively reviewed. Forty-nine patients were included in this study. Various nail alterations were observed in 17 of the 49 patients (34.7%). Onycholysis and subungual hyperkeratosis were observed in 22.4% and 10.2% of patients, respectively. The number of docetaxel administration cycles was correlated with the incidence and severity of nail alterations. Univariate and multivariate analysis clearly demonstrated that the occurrence of nail alterations was an independent favorable prognostic factor for overall survival. Nail alterations associated with treatment may act as a surrogate marker for the efficacy of low-dose metronomic docetaxel chemotherapy.
Collapse
Affiliation(s)
- Kayoko Kibata
- First Department of Internal Medicine, Kansai Medical University, Moriguchi, Osaka 570-8506, Japan
| | | | | | | | | | | |
Collapse
|
18
|
Taxane-induced nail changes: Predictors and efficacy of the use of frozen gloves and socks in the prevention of nail toxicity. Eur J Oncol Nurs 2012; 16:270-5. [DOI: 10.1016/j.ejon.2011.06.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Revised: 06/09/2011] [Accepted: 06/20/2011] [Indexed: 11/22/2022]
|
19
|
Abstract
Fingernails and toenails are important organs of our body, serving as protection for the tips of fingers and toes. Fingernails also enhance fine touching and tactile sensitivity, as well as aid in the picking up of small objects. Healthy-looking nails are an important part of an individual's body image, and any nail abnormalities may be considered by patients as a significant cosmetic problem, markedly influencing their self-esteem. However, recent data have indicated that nail lesions are not only important because of cosmetic disfigurement, but may be a symptom of significant morbidity. Severe nail involvement was also shown to negatively impair social functioning and to interfere with work ability, thus markedly influencing a patient's well-being. Based on literature data and our own experience we conclude that nail diseases cause a marked decrease in health-related quality of life in a substantial percentage of patients. Nail changes are an important medical concern for patients and, therefore, nail diseases should raise attention and receive proper care from both physicians and other healthcare providers.
Collapse
Affiliation(s)
- Adam Reich
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | | |
Collapse
|
20
|
Allende I, González-Hermosa R, Lázaro M, Díaz-Pérez J. Psoriasis inducida por docetaxel. ACTAS DERMO-SIFILIOGRAFICAS 2009; 100:629-30. [PMID: 19715656 DOI: 10.1016/s0001-7310(09)71919-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
|
21
|
Baker J, Ajani J, Scotté F, Winther D, Martin M, Aapro MS, von Minckwitz G. Docetaxel-related side effects and their management. Eur J Oncol Nurs 2009; 13:49-59. [PMID: 19201649 DOI: 10.1016/j.ejon.2008.10.003] [Citation(s) in RCA: 171] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Docetaxel is an effective treatment approved in five key cancers, but its effectiveness in clinical practice can be compromised by sub-optimal side-effect management. The aim of this review was to investigate the extent of the published work on specific docetaxel-related side effects and to provide, where possible, evidence-based recommendations for their prevention and management. PubMed and the American Society of Clinical Oncology (ASCO) databases were systematically searched for articles published in English over the past 5 years and 2 years, respectively, and pertaining to six side effects identified as being common to the majority of docetaxel regimens and indications and of particular relevance to the oncology nurse. The Cochrane library was also searched. A total of 103 citations were identified, 14 of which discussed strategies for the prevention or management of febrile neutropenia (n=6), hypersensitivity reactions (3), fluid retention (1) and nail changes (4). No articles were identified that related to asthenia or neuropathy. Based on the literature review, evidence/guidelines-based advice for the use of G-CSF in febrile neutropenia is provided. The evidence base with respect to the other side effects does not permit the formulation of recommendations. It is the experience of the authors, however, that the severity of symptoms experienced by patients is generally mild and the side effects are for the most part easily managed with prophylactic and supportive care measures. It is, therefore, important to share and build on experiences, through research and discussion, to maximise the healthcare professional's ability to offer the best standard of care to patients.
Collapse
Affiliation(s)
- Jackie Baker
- University of Texas MD Anderson Cancer Center, Gastrointestinal Medical Oncology, Faculty Center, Houston, TX 77030, USA.
| | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
Purpose. To provide a comprehensive literature review of chemotherapy-induced nail toxicity, including clinical presentation, implicated drugs and approaches for prevention and management. Data sources. A search of MEDLINE and EMBASE (1966—2008) databases was conducted using the terms (and variations of the terms) antineoplastic agents, nails, nail toxicity, onycholysis, and paronychia. Bibliographies from selected articles were reviewed for appropriate references. Data extraction. The retrieved literature was reviewed to include all articles relevant to the clinical presentation, diagnosis, incidence, prevention, and treatment of chemotherapy-induced nail toxicity. Data synthesis. Nail toxicity is a relatively uncommon adverse effect linked to a number of chemotherapeutic agents. Clinical presentation varies, depending on which nail structure is affected and the severity of the insult. Nail changes may involve all or some nails. Toxicity may be asymptomatic and limited to cosmetic concerns, however, more severe effects, involving pain and discomfort can occur. Taxanes and anthracyclines are the antineoplastic drug groups most commonly implicated. It is suggested that the administration schedule may influence the incidence of nail abnormalities, for example reported cases linked to the weekly administration of paclitaxel. Before instituting chemotherapy, patients should be educated regarding potential nail toxicities and strategies for prevention implemented. Management includes appropriate nail cutting, avoiding potential irritants, topical, or oral antimicrobials, and possibly cessation or dose reduction of the offending agent. Cryotherapy, through the application of frozen gloves or socks, has been beneficial in reducing docetaxel-induced nail toxicity and may be effective for other drugs. J Oncol Pharm Practice (2009) 15: 143—155.
Collapse
Affiliation(s)
- Peter Gilbar
- Department of Pharmacy, Toowoomba Health Services, PMB 2, Toowoomba, Australia,
| | - Alice Hain
- Department of Pharmacy, Toowoomba Health Services, PMB 2, Toowoomba, Australia
| | | |
Collapse
|
23
|
Allende I, González-Hermosa R, Lázaro M, Díaz-Pérez J. Docetaxel-induced Psoriasis. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s1578-2190(09)70139-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|