Incidence and Management of Cutaneous Toxicities Associated with Cetuximab

Cetuximab, a monoclonal antibody targeting the EGF receptor, was used in treating various cancers, including metastatic colorectal cancer (CRC). It was approved by the FDA for use with irinotecan or as a single agent in irinotecan-intolerant patients. Common toxicities included rash, diarrhea, fever, headache, nausea, hypomagnesemia, and hypersensitivity reactions. Clinical trials showed a 90% incidence of rash in patients, with severe skin reactions in up to 16%. The rash, often acneiform, resulted from disruptions in hair follicle development. There were no standardized treatments for the rash, with management based on personal or institutional experience using antibiotics, steroids, and immunomodulatory agents. Understanding and managing these toxicities was crucial as cetuximab use increased in oncology.