Treatment strategies of epidermal growth factor receptor inhibitor-induced skin toxicities: pre-emptive or reactive?

Epidermal growth factor receptor (EGFR) is known to be over-expressed in many different types of cancers, including lung cancer, breast cancer, colorectal cancer, and so on (1). Treatments targeting on EGFR signaling pathway provide better responses in these cancer patients harboring mutations in EGFR gene (2,3). However, adverse effects due to these EGFR inhibitors might lead to a poor drug adherence or discontinued usages of these agents (4). Skin toxicities are commonly encountered adverse effects during the treatment of EGFR inhibitors. Four major skin toxicities have been identified, including papulopustular (acneiform) eruptions, xerosis, pruritus, and paronychia. Therefore, management of these skin toxicities has a critical role in reducing patients’ discomforts, improving patients’ quality of life, maintaining usage of these agents, and further having a better prognosis (5).