Early skin treatment that is initiated prior to the start of EGFR treatment with Vectibix® (panitumumab) reduces the incidence and severity of skin toxicity and improves quality of life in patients with metastatic colorectal cancer, according to the results of a study presented at the 2009 annual meeting of the American Society of Clinical Oncology in Orlando, Florida.
Colorectal cancer remains the second leading cause of cancer-related deaths in the United States. Metastatic colorectal cancer refers to cancer that has spread from the colon to distant sites in the body. Metastatic colorectal cancer largely remains an incurable disease, and as such patients are treated with the goal of extending survival and maintaining or improving quality of life.
Vectibix is a new targeted therapy that binds to specific targets on cancer cells. Vectibix targets the epidermal growth factor receptor (EGFR), a biologic pathway that is involved in the growth and spread of cancer. Vectibix, which is FDA approved, is often used in combination with chemotherapy for the treatment of colorectal cancer.
The main side effects associated with Vectibix are skin reactions. These reactions can be mild to severe and often adversely affect a patient’s quality of life. Researchers have been evaluating ways to minimize these side effects.
Researchers from several institutions in the United States recently conducted a trial, referred to as the STEPP trial, which compared two different approaches aimed at minimizing skin reactions associated with treatment with Vectibix. This trial included 95 patients with metastatic colorectal cancer who were treated with Vectibix plus a Camptosar® (irinotecan)-based chemotherapy regimen once their disease progressed. Patients were divided into two groups: one group (48 patients) received preemptive skin treatment, which started the day before beginning therapy and continued through the sixth week of therapy, while the other group (47 patients) received reactive treatment, only after an acne-like rash appeared. The skin treatment included multiple daily applications of skin moisturizer, sunscreen, topical steroids, and administration of the antibiotic doxycycline.
Of patients in the preemptive skin treatment group, 29% experienced skin toxicity (grade 2 or higher) compared with 62% of patients in the control group. Patients in the preemptive group reported experiencing a better quality of life during the study than those in the control group.
The researchers concluded that preemptive skin treatment helped reduce skin toxicity associated with EGFR treatment and improve quality of life in patients undergoing this treatment while still maintaining the anti-tumor efficacy of the treatment. Further study is warranted.
 Mitchell EP, Lacouture M, Shearer H, et al. Final STEPP results of prophylactic versus reactive skin toxicity (ST) treatment (tx) for panitumumab (pmab)-related ST in patients (pts) with metastatic colorectal cancer (mCRC). Presented at the 2009 annual meeting of the American Society of Clinical Oncology, May 29-June 2, 2009, Orlando, FL. Abstract CRA4027.