Clinical Research Of Dermatologic Adverse Events Induced By Epidermal Growth Factor Receptor Inhibitors

Objective1.To observe and summarize the types and rash severity of dermatologic adverse events induced by EGFRIs-therapy.2.To analyze the mutual correlation between the severity of dermatologic adverse events induced by afatinib therapy and its anti-tumor efficacy.3.To explore that the serum level of CCL27 may increase in the afatinib-treated patients and be related to the rash severity of dermatologic adverse events.MethodsThis study analyzed that patients were treated with EGFRIs at the hospital from December 2016 to January 2018.1.Clinical data collection1.1 The patients' gender,age,weight,tumor type,the type of EGFRIs,EGFR mutation gene and chest computed tomography were recorded.1.2 The types and rash severity of dermatologic adverse events induced by afatinib were evaluated by NCI-CTCAE 4.0.2.Dermatologic adverse events induced by afatinib and its anti-tumor efficacy2.1 The anti-tumor efficacy of afatinib was evaluated by RECIST.2.2 Patients treated by afatinib were divided into 4 groups according to the rash severity of dermatologic adverse events,and each group was analyzed by the chi-square test with the anti-tumor efficacy of afatinib.3.The correlation between the serum levels of CCL27 detected by ELISA and dermatologic adverse events was analyzed by the rank sum test.Results3.1 105 patients treated with EGFRIs were included in this study and there were 98 patients presenting dermatologic adverse events(93.3%),including acneiform rash,paronychia,oral mucosal erosion,nasal mucosal erosion,hair changes,hand-foot syndrome,and others.Incidence: Acneiform rash(58.1%)> Gonorrhea> Mucosal damage> Hand-foot syndrome> Hair change> Others.The severity of rash is mainly grade 1 and grade 2.3.2 Among 76 patients treated with afatinib,the grade 1 and 2 groups were positively correlated with the anti-tumor efficacy respectively(P=0.032,P=0.011),while the grade 3 group was not associated with anti-tumor efficacy(P=0.742).3.3 The serum levels of CCL27 in 18 patients treated with afatinib were positively correlated with the rash severity(P<0.05).Conclusions1.Acneiform rash is the most common dermatologic adverse events induced by EGFRIs.The grade of rash severity is mainly grade 1 and 2.Normality or grade 3is rare.2.The rash severity is positively correlated with the anti-tumor efficacy of afatinib.The higher the rash severity grading was,the better the anti-tumor efficacy was.3.The serum level of CCL27 is positively correlated with the rash severity.The higher serum level of CCL27 was,the more severe the rash was.