Katsuhiro Masago1,2, Kei Irie3, Shiro Fujita1,2, Fumiko Imamichi4, Yutaka Okada3, Nobuyuki Katakami2, Shoji Fukushima5, Yasushi Yatabe1. 1. Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan. 2. Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe, Japan. 3. Division of Pharmacy, Institute of Biomedical Research and Innovation, Kobe, Japan. 4. Division of Nursing Department, Institute of Biomedical Research and Innovation, Kobe, Japan. 5. Department of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan.
Abstract
PURPOSE: The purpose of the study was to evaluate the site of paronychia in patients with non-small cell lung cancer harboring an epidermal growth factor receptor (EGFR) gene activating mutation who were treated with EGFR tyrosine kinase inhibitors (EGFR TKIs). PATIENTS AND METHODS: The study included 55 patients with non-small-cell lung cancer who were treated with an EGFR TKIs. Resulting all toxicities were graded using the Common Terminology Criteria for Adverse Events version 4.0 system. Drug concentrations were determined with use of a quantum triple-quadrupole mass spectrometer and dried blood spots testing. RESULTS: Paronychia most commonly occurred in the thumb and the big toe. There was no correlation between the severity of paronychia and the drug concentration of each EGFR TKI at the site of paronychia. The mean penetration rates of the drug from plasma to the tip of the finger and toe were 74.1% (erlotinib), 82.2% (gefitinib), and 99.9% (afatinib). CONCLUSIONS: High concentrations of an EGFR TKI at the affected site did not play a role in the onset mechanism of paronychia. Therefore, educating patients about ways to avoid compression may be a better approach to managing this adverse event than reducing the dose of the EGFR-TKI or stopping treatment.
PURPOSE: The purpose of the study was to evaluate the site of paronychia in patients with non-small cell lung cancer harboring an epidermal growth factor receptor (EGFR) gene activating mutation who were treated with EGFR tyrosine kinase inhibitors (EGFR TKIs). PATIENTS AND METHODS: The study included 55 patients with non-small-cell lung cancer who were treated with an EGFR TKIs. Resulting all toxicities were graded using the Common Terminology Criteria for Adverse Events version 4.0 system. Drug concentrations were determined with use of a quantum triple-quadrupole mass spectrometer and dried blood spots testing. RESULTS:Paronychia most commonly occurred in the thumb and the big toe. There was no correlation between the severity of paronychia and the drug concentration of each EGFR TKI at the site of paronychia. The mean penetration rates of the drug from plasma to the tip of the finger and toe were 74.1% (erlotinib), 82.2% (gefitinib), and 99.9% (afatinib). CONCLUSIONS: High concentrations of an EGFR TKI at the affected site did not play a role in the onset mechanism of paronychia. Therefore, educating patients about ways to avoid compression may be a better approach to managing this adverse event than reducing the dose of the EGFR-TKI or stopping treatment.
Authors: Kara D Capriotti; Milan Anadkat; Jennifer Choi; Benjamin Kaffenberger; Beth McLellan; Samuel Barone; Oluwaseun Kukoyi; Shari Goldfarb; Mario Lacouture Journal: Invest New Drugs Date: 2019-06-26 Impact factor: 3.850