new article on dermatologic side effects of lapatinib (tykerb)

[Lani]

: Breast Cancer Res Treat. 2008 Jul 4. [Epub ahead of print] Links
Analysis of dermatologic events in patients with cancer treated with lapatinib.

Lacouture ME, Laabs SM, Koehler M, Sweetman RW, Preston AJ, Di Leo A, Gomez HL, Salazar VM, Byrne JA, Koch KM, Blackwell KL.
Department of Dermatology, Northwestern University, 676 North St. Claire Street, Suite 1600, Chicago, IL, 60611-2941, USA, m-lacouture@northwestern.edu.
Purpose Dermatologic events (DEs) in patients with cancer treated with lapatinib, a small-molecule dual tyrosine kinase inhibitor (TKI) of epidermal growth factor receptor (EGFR [ErbB1]) and HER2 (ErbB2), were characterized. Patients and methods Nine clinical trials of metastatic cancer were included in this analysis. Lapatinib was administered at doses ranging from 1000 to 1500 mg/day as monotherapy (n = 928) or in combination with paclitaxel or capecitabine (n = 491). Patients not treated with lapatinib comprised the control group. Dermatologic events included hand-foot syndrome, rash, hair disorder, dry skin, pruritus/urticaria, skin disorder, skin infection, and nail disorder; DEs were characterized based on type, time to onset, severity, duration, and required interventions. Results Fifty-eight percent of patients treated with lapatinib monotherapy, 74% treated with lapatinib plus paclitaxel or capecitabine, and 53% in the control group developed DEs. Among patients receiving lapatinib monotherapy, 55% experienced grade 1/2 DEs, 3% had grade 3 DEs, and no grade 4 DEs were observed. The most common DE was rash (43%); all other events occurred in </=8% of patients. Most DEs developed between days 1 and 14 of starting treatment, with a median duration of 29 days. Three percent of DEs led to lapatinib dose reduction, 7% resulted in dose interruption, and 1% led to drug discontinuation. Conclusions Most DEs in lapatinib-treated patients present early, are mild to moderate in severity, and infrequently require dose modification or treatment interruption. Lapatinib-associated DEs appear to differ clinically from those associated with EGFR TKIs in both frequency and severity.
PMID: 18600445

[hutchibk]

Interesting about 'hair disorder' - I didn't realize that was part of the Tykerb side effect. I always attributed it to the chemo, Xeloda. Luckily I have hair (thank goodness, as I am not a very confident bald person) but after finishing Herceptin/Taxol and switching to Tykerb/Xeloda, it grew back much, much, much thinner than normal, and it never gets thicker. It also seems to go thru mild thinning phases every 3 months or so. I'm not complaining, but it's interesting to learn that the Tykerb also speaks to this issue for me.

Thanks Lani!

[Kathy S in Tokyo]

This is interesting and useful. Tykerb is still in trials here in Japan and won't be available to the likes of me until at least December but it's what my onco is dangling as my carrot while I circle around the air traffic contol tower on Xeloda and Herceptin. I haven't noticed any rashes on my hands and feet from the Xeloda but the soles of my feet are very tender these days.