Reactions 1247 - 11 Apr 2009

SCetuximab

Skin eruptions and mucositis in patientsreceiving concomitant radiotherapy: 13 casereports

Ten men and three women with locally advanced headand neck squamous cell carcinoma developed skineruptions and mucositis during treatment with cetuximab[duration of treatment to reaction onset not clearly statedfor all patients] and concomitant radiotherapy.

The thirteen patients, who were aged 52–82 years andinvolved in a study, were to receive a cetuximab loadingdose of 400 mg/m2 by IV infusion one week prior, followedby 250 mg/m2 weekly with radiotherapy, 70Gy in 35 dailyfractions, 5 days a week, over 7 weeks; patients received atotal cetuximab dose of 650–2150 mg/m2 .

Three patients had developed grade ≥ 3 skin reactions by28, 36 and 40 Gy, respectively. Seven patients haddeveloped grade ≥ 3 skin reactions by 50 Gy and, by he endof treatment, 10 patients had developed grade ≥ 3 skinreactions. Six patients developed a grade 3 acneiform rashwithin 2–4 weeks of receiving the cetuximab loading dose.An acneiform rash of any grade occurred in 11 patients. Atfollow-up 6 weeks after radiotherapy, acute skin reactionshad resolved without obvious scarring in the 12 patientswho were available for assessment. Ten patients developedgrade 3 mucositis and three patients developed grade2 mucositis; five patients developed grade 3 mucositis bythe end of the third week of radiotherapy.

Only four patients finished the full 8 weeks of cetuximabtherapy. Reasons for treatment cessation were as follows:grade 3/4 skin toxicity (7 patients), florid urticarial rashdespite corticosteroid therapy (1) and progression ofsynchronous lung cancer (1). Four patients required enteralfeeding during treatment because of significant mucositisand dysphagia. Six patients required unplannedhospitalisation for management of severe skin and/ormucosal toxicities. [Patient outcomes not clearly stated.]Pryor DI, et al. Enhanced toxicity with concurrent cetuximab and radiotherapy inhead and neck cancer. Radiotherapy and Oncology 90: 172-176, No. 2, Feb 2009 -Australia 801126358

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Reactions 11 Apr 2009 No. 12470114-9954/10/1247-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved