Some of the most common side effects we hear about from metastatic colorectal cancer patients on Epidermal Growth Factor Receptor Inhibitors (EGFRI) such as Erbitux (also known as Cetuximab) and Vectibix (also known as Panitumumab) are dry skin, acne and rashes. A proactive approach to managing the side effects before, during and after treatment, will help you be on the offensive and lessen the negative impact.
What is Epidermal Growth Factor Receptor (EGFR)?
Epidermal Growth Factor Receptor (EGFR) is located on tumor cells and many skin cells. When growth factors bind to their receptors they signal the cell to divide and grow. EGFR is the target of cetuximab and panitumumab which prevent the binding of growth factors to EGFR stopping cell growth and thereby causing the cell to die.
What to do before treatment
GET YOUR TUMOR TESTED.
These drugs only work on patients who do not have a certain genetic mutation and have normal (wild type) KRAS tumors. Make sure that you know these drugs can work for you!
FIND A GOOD DERMATOLOGIST.
90% of patients experience an acne-like pimply rash on the face, neck, upper chest, scalp and back. A good dermatologist can help with medicines so you can remain on treatment for as long as possible. If you develop a rash, it will typically subside after you complete treatment.
What to do during & after treatment
- Antihistamines, topical or oral, may also help with itching. If the rash is severe, your doctor can prescribe oral corticosteroids, prednisone or dexamethasone. The rash will typically subside after you complete treatment.
- Avoid sun exposure, wear SPF 15+ and protective clothing. Sunlight makes the rash worse.
- Use a hypoallergenic lotions twice per day. Common brands include Eucerin, Aveeno, Vanicream and Cetaphil.
- Apply bath oils – baby, mineral, herbal, Lubriderm or Neutrogena – to your wet skin after your shower or bath.
- Avoid hot showers and bubble baths.
- Drink plenty of fluids.
- Use mild detergents and soaps to wash your skin and clothes.
- Don’t shave your face/legs for a few days to give your skin a rest.
- Paronychia may appear several months after starting the treatment and last several months after. Your nails may become inflamed, brittle and may even loosen from the nail bed. Nail polish is alright to use, but avoid artificial nails.
- Don’t bite your nails or cut your cuticles. Keep both toenails and fingernails clean and dry.
- Your hair may become fine, brittle or curly. Your eyelashes may grow so long they bother your eyes. Once treatment is stopped, this will resolve on its own.
Will these drugs work on every tumor type?
No. It’s very important that you talk to your medical professional about getting your tumor-type tested. These drugs will only work if your tumor is KRAS wild-type/normal.
Mon–Fri, 11:30–NOON ET
Informal, moderated chats for anyone newly diagnosed seeking help and support, including managing treatment side effects (rash management, nausea, neuropathy, diarrhea, etc.)
Watch: EGFR Inhibitors Rash Management: Prevention Is Key