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Clin Colorectal Cancer. 2014 Mar;13(1):62-7. doi: 10.1016/j.clcc.2013.10.001. Epub 2013 Nov 13.

Pilot clinical trial on the efficacy of prophylactic use of vitamin K1-based cream (Vigorskin) to prevent cetuximab-induced skin rash in patients with metastatic colorectal cancer.

Author information

  • 1Colorectal Cancer Unit, Medical Oncology 1 Division, San Giovanni Battista Hospital, Turin, Italy.
  • 2Colorectal Cancer Unit, Medical Oncology 1 Division, San Giovanni Battista Hospital, Turin, Italy. Electronic address: agoponz@hotmail.com.

Abstract

BACKGROUND:

Cetuximab is an effective option for the treatment of metastatic colorectal cancer in the first and subsequent lines of treatment; among its side effects, acneiform skin rash is one of the major causes of treatment delay, reduction, or interruption, with a negative effect on quality of life. No effective strategy to prevent skin rash induced by epidermal growth factor receptor inhibitors is available; however, encouraging results have come from vitamin K1, phytomenadione, applied as a topical formulation. Available studies have been conducted in heterogeneous populations and are mainly focused on the use of vitamin K1-based cream for the treatment, rather than the prophylaxis, of acneiform rash.

PATIENTS AND METHODS:

Forty-one consecutive patients from a single center all affected by metastatic colorectal cancer and receiving cetuximab, alone or combined with chemotherapy, applied vitamin K1-based cream to prevent the occurrence of acneiform skin rash. The cream was applied twice a day on the face and trunk from the first day of administration of cetuximab.

RESULTS:

The application of the cream was well tolerated. No grade 4 rash was reported. The proportion of grade 3 skin rash in the first 8 weeks of treatment in this population was 15%, at the lower limit of values reported in the literature, and the proportion of patients with grade 2 rash was reduced (22.5%).

CONCLUSION:

This experience confirms available data in a homogeneous population, suggesting a possible benefit of topical vitamin K1 as prophylaxis for cetuximab-induced skin rash in patients with metastatic colorectal cancer.

Copyright © 2014 Elsevier Inc. All rights reserved.

KEYWORDS:

Acneiform rash; Cetuximab plus chemotherapy; Phytomenadione; Prevention; Topical treatment

PMID:
24332355
[PubMed - indexed for MEDLINE]
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