Acneiform rash during lung cancer therapy with erlotinib (Tarceva(®))

The Use of Ziziphus spina-christi Extract in Treating Erlotinib (Tarceva®) Associated Rash: A Case Report

The most common side effect for cancer patients using epidermal growth factor receptor inhibitors (EGFRI) is the development of an itchy papulopustular rash. In severe cases, the patients are forced to stop taking the medications, hence affecting treatment outcomes. We herein report a case of a 50-year-old patient who developed a papulopustular rash after starting erlotinib. He treated himself with Ziziphus spina-christi leaves which is a plant well known for its anti-inflammatory and antibacterial properties in the middle east. We hypothesize that the anti-inflammatory, soothing, and antibacterial activity of the Ziziphus tree might actually represent a possible better treatment of the rash than available treatments, particularly in patients on EGFR blockers, and hence improve treatment outcomes.

EGFR Inhibitors-related Panniculitis: A New Side Effect

Epidermal growth factor receptor (EGFR) inhibitors are widely used in the treatment of advanced malignancies, and their skin toxicity is frequent and well recognized in the literature. We report the case of a 69-year-old patient with a history of adenocarcinoma of the lung treated with several EGFR inhibitors and the development of skin lesions compatible with panniculitis. The reproducibility of the lesions with different inhibitors reinforces the causal relationship with the drug, representing the first report in the literature of this side effect.

Complete Regression of Advanced Pancreatic Ductal Adenocarcinomas upon Combined Inhibition of EGFR and C-RAF

Five-year survival for pancreatic ductal adenocarcinoma (PDAC) patients remains below 7% due to the lack of effective treatments. Here, we report that combined ablation of EGFR and c-RAF expression results in complete regression of a significant percentage of PDAC tumors driven by Kras/Trp53 mutations in genetically engineered mice. Moreover, systemic elimination of these targets induces toxicities that are well tolerated. Response to this targeted therapy correlates with transcriptional profiles that resemble those observed in human PDACs. Finally, inhibition of EGFR and c-RAF expression effectively blocked tumor progression in nine independent patient-derived xenografts carrying KRAS and TP53 mutations. These results open the door to the development of targeted therapies for PDAC patients.