INTRODUCTION: Erlotinib is useful in advanced non-small cell lung cancer although compliance and efficacy are diminished by skin rash in a high proportion of patients, often necessitating dose reduction or drug withdrawal. No effective treatment for the rash is available. METHODS: We carried out a preliminary investigation on isotretinoin and clindamycin. Among 56 advanced lung cancer patients treated with erlotinib, 31 (53%) developed rash. Seven (35%) of the 20 G2/G3 cases agreed to treatment with clindamycin (450 mg/d, days 1-10; 300 mg/d, days 11-20) plus isotretinoin (20 mg/d, days 11-20) after being informed of the experimental nature of the combination. RESULTS: In 6 of 7 (86%) patients, the rash resolved (G1/G0) without dose reduction; in the other patient (G3), the erlotinib dose also had to be reduced. Median time to resolution was 14 days (range 7-20 days). No rash-treatment adverse events occurred during 20 days of administration. CONCLUSIONS: Isotretinoin plus clindamycin promises to be the first effective treatment for erlotinib rash and is being tested further.
Isotretinoin plus clindamycin seem highly effective against severe erlotinib-induced skin rash in advanced non-small cell lung cancer / P. Bidoli, D. Cortinovis, I. Colombo, A. Crippa, F. Cicchiello, F. Villa, M. Cazzaniga, G. Altomare. - In: JOURNAL OF THORACIC ONCOLOGY. - ISSN 1556-0864. - 5:10(2010), pp. 1662-1663. [10.1097/JTO.0b013e3181ec1729]
Isotretinoin plus clindamycin seem highly effective against severe erlotinib-induced skin rash in advanced non-small cell lung cancer
D. CortinovisSecondo
;F. Villa;M. CazzanigaPenultimo
;G. AltomareUltimo
2010
Abstract
INTRODUCTION: Erlotinib is useful in advanced non-small cell lung cancer although compliance and efficacy are diminished by skin rash in a high proportion of patients, often necessitating dose reduction or drug withdrawal. No effective treatment for the rash is available. METHODS: We carried out a preliminary investigation on isotretinoin and clindamycin. Among 56 advanced lung cancer patients treated with erlotinib, 31 (53%) developed rash. Seven (35%) of the 20 G2/G3 cases agreed to treatment with clindamycin (450 mg/d, days 1-10; 300 mg/d, days 11-20) plus isotretinoin (20 mg/d, days 11-20) after being informed of the experimental nature of the combination. RESULTS: In 6 of 7 (86%) patients, the rash resolved (G1/G0) without dose reduction; in the other patient (G3), the erlotinib dose also had to be reduced. Median time to resolution was 14 days (range 7-20 days). No rash-treatment adverse events occurred during 20 days of administration. CONCLUSIONS: Isotretinoin plus clindamycin promises to be the first effective treatment for erlotinib rash and is being tested further.Pubblicazioni consigliate
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