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Johnson K, Stoffel B, Schwitter M, Hayoz S, Rojas Mora A, Fischer Maranta A, El Saadany T, Hasler U, von Moos R, Patzen A, Mark M, Roberts G, Cathomas R. Prevention of taxane chemotherapy-induced nail changes and peripheral neuropathy by application of extremity cooling: a prospective single-centre study with intrapatient comparison. Support Care Cancer 2024; 32:554. [PMID: 39066890 PMCID: PMC11283420 DOI: 10.1007/s00520-024-08737-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 07/12/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE Common side effects of taxane chemotherapy are nail toxicity and peripheral neuropathy (CIPN) causing severe impact on the quality of life. Different methods of cryotherapy to prevent these side effects have been tested. We investigated the use of machine-controlled cooling of hands and feet to reduce nail toxicity and CIPN in patients receiving taxane chemotherapy. METHODS Patients receiving Docetaxel (planned dose ≥ 300 mg/m2) or Paclitaxel (planned dose ≥ 720 mg/m2 - ) in the adjuvant or palliative setting of different cancers were included. The dominant hand and foot were cooled to approximately 10 °C using the Hilotherapy machine. The contralateral hand and foot were used as intrapatient comparison. The primary endpoint was the occurrence of any CIPN due to paclitaxel or nail toxicity due to Docetaxel. Both the intention to treat population (ITT) and the per protocol population (PPP) were analyzed. RESULTS A total of 69 patients, 21 treated with Docetaxel and 48 with Paclitaxel, were included at our centre between 08/2020 and 08/2022. Nail toxicity due to Docetaxel was overall not significantly improved by cooling in the ITT or PPP but a significant benefit across visits was found for the ITT. CIPN due to Paclitaxel was numerically better in the ITT and significantly better in the PPP. A significant benefit of cooling on CIPN occurrence across visits was found for the ITT and the PPP. Cooling was very well tolerated. CONCLUSION Cooling of hands and feet has a clinically meaningful impact on reducing occurrence of CIPN and nail toxicity on treatment with taxanes. Effects are more significant over time and are dose dependent. TRIAL REGISTRATION NUMBER 2020-00381. Date of registration. 24th February 2020.
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Affiliation(s)
- Kristen Johnson
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
- Department of Internal Medicine, Kantonsspital Graubünden, Chur, Switzerland
| | - Barbara Stoffel
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Michael Schwitter
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | | | | | | | - Tämer El Saadany
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Ursula Hasler
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Roger von Moos
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Annalea Patzen
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Michael Mark
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Gillian Roberts
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - Richard Cathomas
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland.
- University of Zürich, Zurich, Switzerland.
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Park DJ, Kwon TG, Park JY, Joung JY, Ha HK, Jeon SS, Hong SH, Park S, Lee SH, Cho JS, Park SW, Kwon SY, Jo JK, Park HS, Lee SC, Kwon DD, Kim SI, Park SH, Kim S, Jeong CW, Kwak C, Choi SH. Comparison of Short-Term Outcomes and Safety Profiles between Androgen Deprivation Therapy+Abiraterone/Prednisone and Androgen Deprivation Therapy+Docetaxel in Patients with De Novo Metastatic Hormone-Sensitive Prostate Cancer. World J Mens Health 2024; 42:620-629. [PMID: 38164028 PMCID: PMC11216961 DOI: 10.5534/wjmh.230104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/30/2023] [Accepted: 07/26/2023] [Indexed: 01/03/2024] Open
Abstract
PURPOSE This study aimed to compare the short-term outcomes and safety profiles of androgen-deprivation therapy (ADT)+abiraterone/prednisone with those of ADT+docetaxel in patients with de novo metastatic hormone-sensitive prostate cancer (mHSPC). MATERIALS AND METHODS A web-based database system was established to collect prospective cohort data for patients with mHSPC in Korea. From May 2019 to November 2022, 928 patients with mHSPC from 15 institutions were enrolled. Among these patients, data from 122 patients who received ADT+abiraterone/prednisone or ADT+docetaxel as the primary systemic treatment for mHSPC were collected. The patients were divided into two groups: ADT+abiraterone/prednisone group (n=102) and ADT+docetaxel group (n=20). We compared the demographic characteristics, medical histories, baseline cancer status, initial laboratory tests, metastatic burden, oncological outcomes for mHSPC, progression after mHSPC treatment, adverse effects, follow-up, and survival data between the two groups. RESULTS No significant differences in the demographic characteristics, medical histories, metastatic burden, and baseline cancer status were observed between the two groups. The ADT+abiraterone/prednisone group had a lower prostate-specific antigen (PSA) progression rate (7.8% vs. 30.0%; p=0.011) and lower systemic treatment discontinuation rate (22.5% vs. 45.0%; p=0.037). No significant differences in adverse effects, oncological outcomes, and total follow-up period were observed between the two groups. CONCLUSIONS ADT+abiraterone/prednisone had lower PSA progression and systemic treatment discontinuation rates than ADT+docetaxel. In conclusion, further studies involving larger, double-blinded randomized trials with extended follow-up periods are necessary.
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Affiliation(s)
- Dong Jin Park
- Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea
| | - Tae Gyun Kwon
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Young Park
- Department of Urology, Korea University Ansan Hospital, Ansan, Korea
| | - Jae Young Joung
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Hong Koo Ha
- Department of Urology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Seong Soo Jeon
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung-Hoo Hong
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sungchan Park
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Seung Hwan Lee
- Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Seon Cho
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Sung-Woo Park
- Department of Urology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Se Yun Kwon
- Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea
| | - Jung Ki Jo
- Department of Urology, College of Medicine, Hanyang University, Seoul, Korea
| | - Hong Seok Park
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Sang-Cheol Lee
- Department of Urology, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Dong Deuk Kwon
- Department of Urology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Sun Il Kim
- Department of Urology, Ajou University School of Medicine, Suwon, Korea
| | - Sang Hyun Park
- Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Soodong Kim
- Department of Urology, Dong-A University College of Medicine, Busan, Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seock Hwan Choi
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
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Kaur J, Gaurav V, Tyagi M. Paclitaxel-Induced Periarticular Thenar Erythema with Onycholysis Syndrome. Skin Appendage Disord 2024; 10:74-77. [PMID: 38313568 PMCID: PMC10836932 DOI: 10.1159/000534118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/12/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Periarticular thenar erythema with onycholysis (PATEO) syndrome is a rare subtype of hand-foot syndrome seen in patients undergoing taxane-based chemotherapy. It presents as erythematous to violaceous plaques on the dorsum of hands, feet, and around the Achilles tendon along with nail changes, particularly onycholysis. Case Presentation A 39-year-old female on paclitaxel chemotherapy for stage IIIA (T3N2aM0) invasive ductal breast carcinoma, presented with mildly tender erythematous to violaceous plaques involving the dorsa of bilateral hands and feet, in the periarticular areas of the Achilles tendon, with facial involvement. All fingernails showed shortening, orange-red chromonychia, Beau's lines, onychoschizia, and subungual debris. The toenail involvement was relatively less severe, with distal onycholysis being the predominant finding. The patient showed significant improvement in cutaneous lesions with topical steroid therapy and was advised cold water immersion during subsequent chemotherapy infusions. Discussion A shorter interval between cycles and a higher cumulative number of cycles correlate with severity of dermatitis and nail involvement. Rarely, periocular and facial involvement can occur concurrently with PATEO syndrome. This case is being reported to increase awareness about this entity facilitating early diagnosis and treatment.
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Affiliation(s)
- Japnoor Kaur
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Gaurav
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Mehul Tyagi
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Narayanan A, Thappa DM, Mithin Kumar B. Docetaxel-Induced Nail Bed Purpura. Dermatol Pract Concept 2023; 13:e2023159. [PMID: 37557160 PMCID: PMC10412027 DOI: 10.5826/dpc.1303a159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 08/11/2023] Open
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5
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Mazzega-Fabbro C, Polesel J, Spazzapan S, Meneghetti L, Montagner D, Tabaro G, Bartoletti M, Puglisi F. Mild cryotherapy for prevention of paclitaxel-induced nail toxicity in breast cancer patients: A phase II single-arm clinical trial. Clin Breast Cancer 2023; 23:447-453. [PMID: 36997403 DOI: 10.1016/j.clbc.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/23/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Nail changes are among the most common dermatological adverse events in paclitaxel-receiving patients. Although effective, low-temperature prophylactic cryotherapy is discomforting and a potential cause of side effects, resulting in low patients' adherence. PATIENTS AND METHODS A phase II single-arm study evaluating mild cryotherapy for the reduction of 12-week, grade 2 nail toxicity was conducted on 67 taxane-naïve breast cancer patients (age 18-74 years) undergoing weekly adjuvant chemotherapy with paclitaxel. Instant-ice packs were fixed over the fingers and toes for a total of 70 minutes during paclitaxel infusion at a temperature between -5 °C and +5 °C. Nail toxicity was evaluated weekly (CTCAE vs 4.03), including grade 2 (ie, onycholysis, subungual hematoma, onychomadesis) and grade 1 nail toxicities. RESULTS Twelve patients experienced grade 2 nail toxicities (17.9%, 95% confidence interval [CI] 9.6%-29.2%; median time to onset: 56 days): onycholysis was the most frequent grade 2 toxicity (13.4%), followed by subungual hematoma (9.0%) and onychomadesis (1.5%). Grade 1 toxicity occurred in 33 patients (63.5%, 95% CI 49.0%-76.4%) with nail discoloration representing by far the most frequent toxicity (59.6%). Seventeen patients (25.4%) reported no nail toxicity. 62.7% of patients reported no pain and 22.4% suffered moderate pain. No patient experienced severe pain or others adverse effects. CONCLUSIONS Instant-ice pack is a feasible prophylactic intervention for nail toxicity, well tolerated by patients and with limited impact on routine workload. It could be considered for patients refusing (or interrupting) cryotherapy, and it can be implemented when frozen gloves management is not feasible.
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Morrison A, Marshall-McKenna R, McFadyen AK, Hutchison C, Rice AM, Stirling L, McIlroy P, Macpherson IR. A randomised controlled trial of interventions for taxane-induced nail toxicity in women with early breast cancer. Sci Rep 2022; 12:11575. [PMID: 35798751 PMCID: PMC9262963 DOI: 10.1038/s41598-022-13327-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 05/06/2022] [Indexed: 11/17/2022] Open
Abstract
Onycholysis and paronychia has been associated with chemotherapy treatment for women with breast cancer. Our primary aim was to investigate the effectiveness of different topical interventions to ameliorate nail toxicity. Secondary aims were to explore the full range and severity of possible nail changes associated with taxane-based chemotherapy and the specific impact this had on quality of life, using two novel measures. This was an exploratory randomised controlled trial of three topical interventions (standard care, nail polish or specialist nail drops) for the prevention or reduction of nail changes induced by taxane-based chemotherapy. Outcomes included nail toxicity assessed at three time points (baseline, 3 weeks and 3 months post completion of chemotherapy) using two novel clinical tools (NToX-G12, NToX-QoL) and the Common Terminology Criteria for Adverse Events (CTCAE v3) and EQ-5D-5L. A total of 105 women were recruited (35 in each arm) and monitored up to three months post completion of chemotherapy. Almost 20% of patients were over the age of 60 years. There were 26 withdrawals, the majority from the nail polish arm. Residual Maximum Likelihood REML analysis indicated a significant arm, time and interaction effect for each intervention (p < 0.001). Less nail toxicity was observed in patients receiving specialist nail drops or standard care arms in comparison to those using nail polish. This study provides evidence to support clinicians’ suggestions on nail care recommendations based on the patients’ needs and preferences. Future investigations into comparing or combining cryotherapy and topical solutions that can support patient’s decisions are warranted.
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Affiliation(s)
- Audrey Morrison
- The Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, Scotland.
| | | | | | - Cathy Hutchison
- The Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, Scotland
| | - Ann-Marie Rice
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, G12 8QQ, Scotland
| | - Lynne Stirling
- The Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, Scotland
| | - Pauline McIlroy
- The Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, Scotland
| | - Iain R Macpherson
- The Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, Scotland.,Institute of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Glasgow, G61 1QH, UK
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7
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Bansal A, Relhan V. Acute and chronic paronychia revisited: A narrative review. J Cutan Aesthet Surg 2022; 15:1-16. [PMID: 35655642 PMCID: PMC9153310 DOI: 10.4103/jcas.jcas_30_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Paronychia refers to the inflammation of the tissue which immediately surrounds the nail and it can be acute (<6 weeks duration) or chronic (>6 weeks duration). Disruption of the protective barrier between the nail plate and the adjacent nail fold preceded by infectious or noninfectious etiologies results in the development of paronychia. A combination of general protective measures, and medical and/or surgical interventions are required for management. This review explores the pathogenesis, clinical features, differential diagnosis, medical, and surgical management of paronychia. For the purpose of this review, we searched the PubMed, Cochrane, and Scopus databases using the following keywords, titles, and medical subject headings (MeSH): acute paronychia, chronic paronychia, and paronychial surgeries. Relevant review articles, original articles, and case reports/series published till February 2020 were included in this study.
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8
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Gupta MK, Lipner SR. Review of chemotherapy-associated paronychia. Int J Dermatol 2021; 61:410-415. [PMID: 34242408 DOI: 10.1111/ijd.15740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 03/18/2021] [Accepted: 05/28/2021] [Indexed: 12/01/2022]
Abstract
Chemotherapy-associated paronychia (CAP) is an inflammation of the nail folds in response to various chemotherapeutic medications. Altered proliferation of keratinocytes or nail matrix stem cells is thought to be a major causative factor. Prophylactic tetracyclines, topical povidone-iodine, and general irritation avoidance measures are among some of the recommended interventions for CAP. Appropriate recognition and treatment of CAP are important for prevention of chemotherapy dose reduction or medication discontinuation.
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Affiliation(s)
- Mohit K Gupta
- College of Medicine, State University of New York Downstate, Brooklyn, New York, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York City, New York, USA
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9
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Anoop TM, Joseph P R, Pn M, Kp P, Gopan G, Chacko S. Cutaneous Toxicities in Breast Cancer Patients Receiving Chemotherapy and Targeted Agents--An Observational Clinical Study. Clin Breast Cancer 2021; 21:e434-e447. [PMID: 33608219 DOI: 10.1016/j.clbc.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/17/2020] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Systemic chemotherapy and targeted agents are associated with various cutaneous toxicities. Even though cutaneous toxicities are manageable, it often results in treatment discontinuation and worsens the patients' quality of life. AIM The study aimed to determine the spectrum of cutaneous toxicities in patients receiving systemic chemotherapy and targeted agents for breast cancer patients. PATIENTS AND METHODS A total of 250 out of 720 patients with breast cancer who developed various cutaneous toxicities to chemotherapeutic or targeted agents were included in the study. RESULTS Among 250 patients, 57 patients were on neoadjuvant chemotherapy, 89 patients were on adjuvant chemotherapy, 68 were on palliative chemotherapy for metastatic breast cancer and 36 were on targeted treatment for metastatic breast cancer. The most frequently affected site was hair (96%), followed by skin (92%), nail (34%), and mucosa (26%). The most common dermatological toxicity noticed in our study involved the hair in the form of chemotherapy induced alopecia (anagen effluvium) in 93.6%, followed by skin toxicity with generalized xerosis in 92% and, nail toxicity in 34%, and mucosal toxicity in 26%. The most common chemotherapeutic agent which caused frequent cutaneous toxicities in our patients was docetaxel followed by paclitaxel, capecitabine, doxorubicin, epirubicine, cyclophosphamide, 5-flurouracil and targeted agents like lapatinib, everolimus, and tamoxifen. CONCLUSION Cutaneous toxicities are common following systemic chemotherapy and targeted agents. Early recognition of cutaneous side effects of these agents and prompt early interventions can reduce the significant morbidity, cosmetic disfigurement, unnecessary treatment interruptions, and psychological distress in women treated for breast cancers.
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Affiliation(s)
- T M Anoop
- Department of Medical Oncology, Regional Cancer Center, Thiruvananthapuram, Kerala, India.
| | - Rona Joseph P
- Department of Medical Oncology, Regional Cancer Center, Thiruvananthapuram, Kerala, India
| | - Mini Pn
- KIMS Hospital, Thiruvananthapuram, Kerala, India
| | - Pranab Kp
- Department of Medical Oncology, Regional Cancer Center, Thiruvananthapuram, Kerala, India
| | - Gayatri Gopan
- Department of Medical Oncology, Regional Cancer Center, Thiruvananthapuram, Kerala, India
| | - Steffi Chacko
- Department of Medical Oncology, Regional Cancer Center, Thiruvananthapuram, Kerala, India
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10
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Lacouture ME, Sibaud V, Gerber PA, van den Hurk C, Fernández-Peñas P, Santini D, Jahn F, Jordan K. Prevention and management of dermatological toxicities related to anticancer agents: ESMO Clinical Practice Guidelines ☆. Ann Oncol 2021; 32:157-170. [PMID: 33248228 DOI: 10.1016/j.annonc.2020.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- M E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - V Sibaud
- Department of Oncodermatology, Claudius Regaud Institute, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - P A Gerber
- Department of Dermatology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - C van den Hurk
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
| | - P Fernández-Peñas
- Department of Dermatology, The University of Sydney, Westmead Hospital, Sydney, Australia
| | - D Santini
- Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy; Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy
| | - F Jahn
- Department of Internal Medicine IV, Hematology, Oncology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - K Jordan
- Department of Medicine V, Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
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Shigematsu H, Hirata T, Nishina M, Yasui D, Ozaki S. Cryotherapy for the prevention of weekly paclitaxel-induced peripheral adverse events in breast cancer patients. Support Care Cancer 2020; 28:5005-5011. [PMID: 32036471 PMCID: PMC7447649 DOI: 10.1007/s00520-020-05345-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/02/2020] [Indexed: 12/26/2022]
Abstract
Purpose This randomized phase II study was conducted to investigate the efficacy of cryotherapy in preventing peripheral neuropathy and dermatological adverse events in breast cancer patients treated with weekly paclitaxel. Methods Patients treated with 12 weekly doses of paclitaxel for breast cancer were randomized (1:1) into a cryotherapy or control group. The primary endpoint was the percentage of patients with a marked decrease in the Functional Assessment of Cancer Therapy-Neurotoxicity (FACT-NTX) score. The secondary endpoints were Patient Neurotoxicity Questionnaire (PNQ), Common Terminology Criteria for Adverse Event (CTCAE) for peripheral neuropathy, and FACT-Taxane score. Results Forty-four patients were randomly assigned to the cryotherapy (n = 22) or control groups (n = 22). The percentage of patients with a marked decrease in FACT-NTX scores was significantly lower in the cryotherapy group than in the control group (41 vs. 73%, p = 0.03). The incidence of CTCAE grade ≥ 2 sensory (p = 0.001) and motor peripheral neuropathy (p = 0.01), and PNQ grade D or higher for sensory peripheral neuropathy (p = 0.02), and decrease in the FACT-Taxane score (p = 0.02) were also significantly lower in the cryotherapy group than in the control group. There were no serious side effects associated with cryotherapy. Conclusion Cryotherapy is an effective approach for prevention of peripheral neuropathy and dermatological adverse events in breast cancer patients treated with weekly paclitaxel.
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Affiliation(s)
- Hideo Shigematsu
- Department of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama-cho, Kure City, Hiroshima, 737-0023, Japan.
| | - Taizo Hirata
- Department of Medical Oncology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Aoyama-cho, Kure City, Hiroshima, Japan
| | - Mai Nishina
- Department of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama-cho, Kure City, Hiroshima, 737-0023, Japan.,Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Daisuke Yasui
- Department of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama-cho, Kure City, Hiroshima, 737-0023, Japan
| | - Shinji Ozaki
- Department of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama-cho, Kure City, Hiroshima, 737-0023, Japan.,Department of Breast Surgery, Hiroshima Prefectural Hospital, Hiroshima, Hiroshima, 734-8530, Japan
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Mehta RD, Trivedi M, Kumar HS, Ghiya BC, Soni P, Meena M, Kumar V, Rekha S. Nail changes caused by chemotherapy among cancer patients: A cross-sectional study of northwest rajasthan. Indian Dermatol Online J 2020; 11:953-958. [PMID: 33344346 PMCID: PMC7734979 DOI: 10.4103/idoj.idoj_84_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/27/2020] [Accepted: 05/21/2020] [Indexed: 11/04/2022] Open
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13
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Fonia A, Richert B. Onychalgia Causes and Mechanisms: The “GIFTED KID” and the “FOMITE”. Skin Appendage Disord 2020; 6:77-87. [DOI: 10.1159/000504347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 10/23/2019] [Indexed: 11/19/2022] Open
Abstract
This article gives an account of the commonest causes of nail pain. The acronyms GIFTED KID and FOMITE will help aid doctors in a busy clinical setting to remember the main causes of onychalgia, respectively, on the fingers and toes. It includes a brief overview of the clinical characteristics and focuses on the type of pain for each condition as well as the mechanisms that cause it.
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14
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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.
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Su MH, Chen GY, Lin JH, Lee HH, Chung KC, Wang PH. Paclitaxel-related dermatological problems: Not only alopecia occurs. Taiwan J Obstet Gynecol 2019; 58:877-879. [DOI: 10.1016/j.tjog.2019.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 01/05/2023] Open
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17
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Capriotti KD, Anadkat M, Choi J, Kaffenberger B, McLellan B, Barone S, Kukoyi O, Goldfarb S, Lacouture M. A randomized phase 2 trial of the efficacy and safety of a novel topical povidone-iodine formulation for Cancer therapy-associated Paronychia. Invest New Drugs 2019; 37:1247-1256. [PMID: 31240513 DOI: 10.1007/s10637-019-00825-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 06/19/2019] [Indexed: 12/26/2022]
Abstract
Purpose Cancer therapy-associated paronychia (CAP) is a frequent adverse event associated with cytotoxic and targeted therapies that may impact dosing of anticancer therapies and patient quality of life (QoL). There are currently no evidence-based management strategies or approved treatments for CAP. Materials and Methods This was a prospective, multicenter, randomized, double-blind, vehicle-controlled phase 2 study that evaluated the efficacy and safety of 6 to 8 weeks of 1% or 2% povidone-iodine (PVP-I) topical solution versus vehicle-control in adult patients with CAP. Patients were randomized to one of three treatment arms administered twice daily: 1% PVP-I (Cohort A), 2% PVP-I (Cohort B), or vehicle-control (Cohort C). The primary endpoint was a two-grade reduction (or reduction to grade 0 if involved nails were grade 1) on the six-point Paronychia Severity Grading (PSG) scale. Secondary endpoints included safety and the effect on QoL and microbiota. Results A total of 102 patients with cancer were randomized to the study. In Cohort A, 83 of 205 (40.5%, P = 0.6059) affected nails met the primary endpoint versus Cohort C. In Cohort B, 88 of 167 (52.7%, P = 0.0063) affected nails met the primary endpoint versus 64 of 169 (37.9%) in Cohort C. Nineteen of 29 patients (65.5%) in Cohort B reported moderately or very painful nails at baseline that decreased to 15 patients (51.7%) at visit 2 and five patients (17.2%) at visit 3. Conclusions Treatment with twice-daily topical 2% PVP-I was safe and resulted in improvement in CAP compared with control. Clinicaltrials.gov identifier: NCT03207906. https://clinicaltrials.gov/ct2/show/NCT03207906.
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Affiliation(s)
- Kara D Capriotti
- Veloce BioPharma LLC, Fort Lauderdale, FL, USA. .,Bryn Mawr Skin and Cancer Institute, 919 Conestoga Road, Building 2, Suite 106, Rosemont, PA, 19010, USA.
| | - Milan Anadkat
- Department of Medicine, Division of Dermatology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Jennifer Choi
- Department of Dermatology, Ohio State University Dermatology, Columbus, OH, USA
| | - Benjamin Kaffenberger
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Beth McLellan
- Department of Medicine, Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Oluwaseun Kukoyi
- Department of Medicine, Dermatology Service, New York, NY, USA.,Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Shari Goldfarb
- Department of Medicine, Dermatology Service, New York, NY, USA.,Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mario Lacouture
- Department of Medicine, Dermatology Service, New York, NY, USA.,Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Huang KL, Lin KY, Huang TW, Loh EW, Hua YM, Su HC, Tam KW. Prophylactic management for taxane-induced nail toxicity: A systematic review and meta-analysis. Eur J Cancer Care (Engl) 2019; 28:e13118. [PMID: 31184794 DOI: 10.1111/ecc.13118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/27/2019] [Accepted: 05/14/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This meta-analysis was performed to assess the efficacy of cryotherapy and nail solution (NS) use in preventing nail toxicity (NT) induced by taxane-based chemotherapy. METHODS PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov registry databases were searched for relevant studies published up to December 2018. The primary outcome was taxane-induced NT. Secondary outcomes were skin toxicity (ST), time to toxicity and patient comfort. RESULTS We reviewed three randomised control trials and six prospective studies with 708 patients. For meta-analysis, taxane-induced NT grading was compared. NT and ST were significantly lower in the cryotherapy patients than in the controls (grade 1 NT: risk ratio [RR] = 0.51, 95% confidence interval [CI] = 0.30-0.89; grade 2-3 NT: RR = 0.36, 95% CI = 0.11-1.12; total NT: RR = 0.49; 95% CI = 0.30-0.79; ST: RR = 0.46, 95% CI = 0.33-0.64). The NS-treated patients exhibited significantly lower NT than the controls. CONCLUSIONS Nail solution-treated or cryotherapy patients exhibited lower NT incidence and severity associated with taxane-based chemotherapy than the controls. For patients who can afford and comply with NS use or cryotherapy, these measures represent effective prophylactic management for taxane-induced NT and improve their quality of life and functional statuses. Further studies are needed to establish the routine usage protocols, long-term efficacy and safety for these interventions.
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Affiliation(s)
- Kai-Ling Huang
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Yu Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tsai-Wei Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
| | - El-Wui Loh
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.,Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Ming Hua
- Department of Pharmacy, Chi Mei Medical Center, Tainan City, Taiwan
| | - Hui-Chen Su
- Department of Pharmacy, Chi Mei Medical Center, Tainan City, Taiwan
| | - Ka-Wai Tam
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.,Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
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Lacouture ME, Kopsky DJ, Lilker R, Damstra F, van der Linden MHM, Freites-Martinez A, Nagel MPM. Podiatric Adverse Events and Foot Care in Cancer Patients and Survivors Awareness, Education, and Literature Review. J Am Podiatr Med Assoc 2018; 108:508-516. [PMID: 30742505 PMCID: PMC8108701 DOI: 10.7547/17-010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cancer is one of the leading causes of mortality and morbidity worldwide. Recent improved therapies have resulted in more patients surviving cancer and living longer. Despite these advances, the majority of patients will develop adverse events from anticancer therapies. Foot alterations, including nail toxicities, hand-foot syndrome, edema, xerosis, hyperkeratosis, and neuropathy, are frequent among cancer patients. These untoward conditions may negatively impact quality of life, and in some cases may result in the interruption or discontinuation of cancer treatments. Appropriate prevention, diagnosis, and management of podiatric adverse events are essential to maintain foot function and health-related quality of life, both of which are critical for the care of cancer patients and survivors. This article shows results related to complaint and impact on quality of life of the Oncology Foot Care program and reviews publications specific to podiatric adverse events related to cancer treatments.
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Affiliation(s)
| | - David J Kopsky
- Institute for Neuropathic Pain, Amsterdam, The Netherlands
| | | | - Fiona Damstra
- Reade Rehabilitation Centre, Amsterdam, The Netherlands
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Chabanol H, Huillard O, Prin L, Villeminey C, Rondeau A, Boudou-Rouquette P, Astorg F, Musenghesi B, Du Mortier C, Alexandre J, Goldwasser F. [Integrated podiatrist care for prostate cancer patients treated with docetaxel: Feasibility and results]. Bull Cancer 2018; 105:1173-1182. [PMID: 30078546 DOI: 10.1016/j.bulcan.2018.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/16/2018] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Docetaxel is frequently used for the treatment of metastatic prostate cancer patients. Nail toxicity is a commonly described side effect, but no precise recommendation exists concerning its management. We experimented the integration of a podiatrist in routine cancer care. METHODS Patients having received docetaxel for a metastatic prostate cancer since the arrival of the podiatrist were studied. RESULTS Fifty-six patients were included, half had docetaxel-induced nail toxicity and 18 were referred to the podiatrist. The integration of the podiatrist in routine care was feasible and allowed characterizing nail toxicity. The main lesions observed were non-coagulated nail hematomas, coagulated nail hematomas and onycholysis. This experience led to propose an integrated care for docetaxel-induced nail toxicity. CONCLUSION The integration of podiatrist care is feasible in routine cancer care and can help improving the management of docetaxel-induced nail toxicity in metastatic prostate cancer patients.
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Affiliation(s)
- Hedi Chabanol
- AP-HP, hôpital Cochin Port-Royal, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France
| | - Olivier Huillard
- AP-HP, hôpital Cochin Port-Royal, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France.
| | - Lucie Prin
- AP-HP, hôpital Cochin Port-Royal, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France
| | - Clémentine Villeminey
- AP-HP, hôpital Cochin Port-Royal, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France
| | - Aurélie Rondeau
- AP-HP, hôpital Cochin Port-Royal, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France
| | - Pascaline Boudou-Rouquette
- AP-HP, hôpital Cochin Port-Royal, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France
| | - Florence Astorg
- AP-HP, hôpital Cochin Port-Royal, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France
| | - Beatrice Musenghesi
- AP-HP, hôpital Cochin Port-Royal, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France
| | - Catherine Du Mortier
- AP-HP, hôpital Cochin Port-Royal, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France
| | - Jerome Alexandre
- AP-HP, hôpital Cochin Port-Royal, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France
| | - Francois Goldwasser
- AP-HP, hôpital Cochin Port-Royal, service de cancérologie, 123, boulevard Port-Royal, 75014 Paris, France
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Affiliation(s)
- Kumpol Aiempanakit
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Capriotti K, Capriotti J, Pelletier J, Stewart K. Chemotherapy-associated paronychia treated with 2% povidone-iodine: a series of cases. Cancer Manag Res 2017; 9:225-228. [PMID: 28721095 PMCID: PMC5500570 DOI: 10.2147/cmar.s139301] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Nail changes are known to occur during the use of chemotherapy for a variety of malignancies, particularly those treated with taxanes and EGFR inhibitors. There are currently no actively recruiting prospective clinical trials investigating potential treatments. There are also no US Food and Drug Administration-approved medical treatments for chemotherapy-associated paronychia and no consensus on the best way to treat these common chemotherapy-induced events. Methods A retrospective review of all cases presenting to a single dermatology private practice from June 2016 to January 2017 identified nine patients with chemotherapy-associated paronychia seeking treatment. Each patient was prescribed a topical solution comprised of 2% povidone–iodine in a dimethylsulfoxide vehicle that was prepared by a licensed compounding pharmacy. Patients were seen at 3 week and 6 week follow-up visits. Results All 9/9 patients demonstrated complete or partial resolution. The number of nails involved for each patient ranged from 4–12. There were a total of 58 nails affected in the case series, and 44/58 (76%) resolved overall. The treatment was well tolerated. Conclusion The topical povidone–iodine/dimethylsufoxide solution described is very effective in alleviating the signs and symptoms of paronychia associated with chemotherapy. This novel combination warrants further investigation in randomized, controlled trials to further elucidate its clinical utility.
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Affiliation(s)
- Kara Capriotti
- Veloce BioPharma LLC, Fort Lauderdale, FL.,Bryn Mawr Skin and Cancer Institute, Rosemont, PA
| | - Joseph Capriotti
- Veloce BioPharma LLC, Fort Lauderdale, FL.,Plessen Ophthalmology Consultants, Christiansted, VI, USA
| | - Jesse Pelletier
- Veloce BioPharma LLC, Fort Lauderdale, FL.,Plessen Ophthalmology Consultants, Christiansted, VI, USA
| | - Kevin Stewart
- Veloce BioPharma LLC, Fort Lauderdale, FL.,Plessen Ophthalmology Consultants, Christiansted, VI, USA
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Abstract
Taxanes (docetaxel and paclitaxel) are among the most commonly prescribed anticancer drugs approved for the treatment of metastatic or locally advanced breast, non-small cell lung, prostate, gastric, head and neck, and ovarian cancers, as well as in the adjuvant setting for operable node-positive breast cancers. Although the true incidence of dermatological adverse events (AEs) in patients receiving taxanes is not known, and has never been prospectively analysed, they clearly represent one of the major AEs associated with these agents. With an increase in the occurrence of cutaneous AEs during treatment with novel targeted and immunological therapies when used in combination with taxanes, a thorough understanding of reactions attributable to this class is imperative. Moreover, identification and management of dermatological AEs is critical for maintaining the quality of life in cancer patients and for minimizing dose modifications of their antineoplastic regimen. This analysis represents a systematic review of the dermatological conditions reported with the use of these drugs, complemented by experience at comprehensive cancer centres. The conditions reported herein include skin, hair, and nail toxicities. Lastly, we describe the dermatological data available for the new, recently FDA-and EMA- approved, solvent-free nab-paclitaxel.
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Kim JY, Ok ON, Seo JJ, Lee SH, Ahn JS, Im YH, Park YH. A prospective randomized controlled trial of hydrating nail solution for prevention or treatment of onycholysis in breast cancer patients who received neoadjuvant/adjuvant docetaxel chemotherapy. Breast Cancer Res Treat 2017; 164:617-625. [DOI: 10.1007/s10549-017-4268-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 04/22/2017] [Indexed: 11/30/2022]
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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.
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Yorulmaz A, Dogan M, Artuz F, Zengin N. Comparison of pigmentary side effects of taxanes and anthracyclines: an onychoscopic evaluation. Cutan Ocul Toxicol 2016; 36:135-139. [DOI: 10.3109/15569527.2016.1173698] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Mutlu Dogan
- Department of Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | | | - Nurullah Zengin
- Department of Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey
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Abstract
Care of the oncologic patient requires an integral understanding of the adverse reactions of chemotherapy. With the advent of targeted agents and immunomodulating therapies, reactions to these newer treatments are of clinical interest. Cutaneous side effects of chemotherapeutic agents, including toxic erythema and mucositis, are common and may require cessation of treatment if associated with discomfort, superinfection, or negative impact on quality of life. This article reviews the cutaneous adverse reactions and treatment options of both conventional cytotoxic chemotherapeutic agents and newer targeted, multikinase inhibitors and immunomodulating therapies. An understanding of possible cutaneous reactions by all providers involved in the care of the oncologic patient is critical for prompt recognition, allowing for appropriate treatment and referral to dermatologists when necessary.
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Affiliation(s)
- Veronica J Shi
- Department of Dermatology, Yale University School of Medicine, New Haven, CT
| | - Lauren L Levy
- Department of Dermatology, Yale University School of Medicine, New Haven, CT
| | - Jennifer N Choi
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL.
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Capriotti K, Capriotti JA. Chemotherapy-associated paronychia treated with a dilute povidone-iodine/dimethylsulfoxide preparation. Clin Cosmet Investig Dermatol 2015; 8:489-91. [PMID: 26445556 PMCID: PMC4590550 DOI: 10.2147/ccid.s90542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Nail changes associated with chemotherapy in general, and particularly with taxane and epidermal growth factor receptor inhibitor-based regimens, are common presentations in our clinical population. Currently, there are no consensuses about therapies supported by clinical trials nor are there any US Food and Drug Administration-approved treatments for this indication. Findings A 42-year-old woman with stage 2A breast cancer presented to our clinic with chemotherapy-induced paronychia. Symptoms were severe enough that cessation of chemotherapy was being considered. The patient’s chemotherapy regimen included doxorubicin, cyclophosphamide, and docetaxel. Conclusion The topical povidone-iodine/dimethylsulfoxide system is very effective in alleviating the signs and symptoms of severe paronychia associated with chemotherapy. This novel combination warrants further investigation in randomized, controlled trials to further elucidate its clinical utility.
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Affiliation(s)
- Kara Capriotti
- ALC Therapeutics, LLC, Springhouse, PA, USA ; Bryn Mawr Skin and Cancer Institute, Rosemont, PA, USA
| | - Joseph A Capriotti
- ALC Therapeutics, LLC, Springhouse, PA, USA ; Plessen Ophthalmology Consultants, Christiansted, VI, USA
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Schepisi G, Conteduca V, Lolli C, Medri M, De Giorgi U. Taxane-related nail toxicity. Lancet Oncol 2015; 16:e310-1. [DOI: 10.1016/s1470-2045(15)00019-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 05/27/2015] [Indexed: 10/23/2022]
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