By inhibiting epidermal growth factor receptor (EGFR) signaling pathways, EGFR inhibitors have shown efficacy in the treatment of a variety of cancers, including non-small cell lung cancer (NSCLC), pancreatic cancer, and colorectal cancer. However, most patients who receive EGFR inhibitors develop adverse skin events, such as acneiform rash, xerosis, paronychial inflammation, pruritis, photosensitivity, and hair and eyelash alteration. If not properly managed, these toxicities can lead to physical discomfort, decreased quality of life and social functioning, and poor therapeutic outcomes.
In a study now published in The Oncologist, Sung Yong Oh, MD, PhD, a Professor in the Department of Oncology at Dong-A University Medical Center in South Korea, and colleagues found that epidermal growth factor (EGF) ointment is effective in facilitating skin regeneration and wound healing in skin toxicities resulting from treatment with EGFR inhibitors in patients with NSCLC, pancreatic cancer, or colorectal cancer. In this interview with i3 Health, Dr. Oh discusses the potential that EGF ointment has to offer for patients experiencing these adverse events.
Can you comment on the significance of your results concerning the use of EGF ointment for patients with NSCLC, pancreatic cancer, or colorectal cancer receiving EGFR inhibitors?
Sung Yong Oh, MD, PhD: The use of EGFR inhibitors has led many patients with metastatic NSCLC, pancreatic cancer, or colorectal cancer to experience greater survival. However, at the same time, EGFR inhibitors result in discomfort caused by adverse skin effects. We wanted to present a new concept of treatment in a situation in which there is not yet a standard treatment for skin toxicities. Rather than using steroids or antibiotics to prevent these adverse events, we tested the use of EGF ointment—nonsteroidal non-antibiotics—for therapeutic purposes.
How does EGF ointment compare with current treatments for EGFR inhibitor-related skin adverse events for patients with NSCLC, pancreatic cancer, or colorectal cancer?
Dr. Oh: The conventional general recommendation is to apply moisturizers or to use steroids and/or antibiotics in grade 2 or 3 adverse events. In this study, we tested an ointment that consisted of existing therapy in combination with additional EGFs and compared that with the control group.
Your results included a 44.4% response rate in the placebo arm. To what do you attribute this finding?
Dr. Oh: Moisturizing creams are commonly used by patients to mitigate skin toxicities. While the placebo group did not contain EGF, it did contain petrolatum, a skin moisturizing agent. Therefore, some patients in the placebo group also experienced a response.
How do you think that your findings will impact current clinical practice for patients with NSCLC, pancreatic cancer, or colorectal cancer experiencing skin toxicities?
Dr. Oh: Early application of EGF ointment, especially in patients experiencing grade 2 or higher events, is expected to help relieve discomfort caused by adverse skin events in patients receiving EGFR inhibitors.
About Dr. Oh
Sung Yong Oh, MD, PhD, is a Professor in the Oncology Department at Dong-A University Medical Center in Busan, South Korea. He has led clinical trials in a variety of topics in oncology, hematology, and internal medicine.
For More Information
Kim YS, Ji JH, Oh SY, et al (2019). A randomized controlled trial of epidermal growth factor ointment for treating epidermal growth factor receptor inhibitor-related skin toxicities. Oncologist. [Epub ahead of print] DOI:10.1634/theoncologist.2019-0221
Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily represent those of i3 Health.