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Therapie mit Inhibitoren des epidermalen Wachstumsfaktorrezeptors

Spektrum kutaner Nebenwirkungen

Therapy with epidermal growth factor receptor inhibitors

Clinical spectrum of cutaneous adverse effects

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Zusammenfassung

In den letzten Jahren konnten Inhibitoren des epidermalen Wachstumsfaktorrezeptors (EGFR) wie Erlotinib, Gefitinib, Cetuximab oder Panitumumab erfolgreich in der Therapie verschiedener solider Tumoren etabliert werden. Als bedeutendste Nebenwirkung dieser sog. „targeted cancer drugs“ kommt es bei 45–100% der behandelten Patienten zu einem breiten Spektrum kutaner Toxizitäten. Diese umfassen neben einem charakteristischen papulopustulösen Exanthem unter anderem schmerzhafte Paronychien, eine Xerosis cutis, Pruritus und Haarwachstumsstörungen. Diese häufig stigmatisierenden Nebenwirkungen stellen eine ernst zu nehmende Gefahr für die Lebensqualität und nicht zuletzt für die Compliance der Patienten dar. Eine Dosisreduktion oder gar Unterbrechung der Tumortherapie können die Folge sein. Vor diesem Hintergrund und in Anbetracht der steigenden Anzahl von Patienten, die einer Therapie mit EGFR-Inhibitoren zugeführt werden, sind diese neuen medikamentenassoziierten Hautveränderungen für den klinischen Alltag von Dermatologen und Onkologen von zunehmender Bedeutung.

Abstract

Recently, inhibitors of the epidermal growth factor receptor (EGFR), such as erlotinib, gefitinib, cetuximab or panitumumab, have been successfully established in the therapy of a variety of solid tumors. Cutaneous adverse effects are the most frequent side-effects of these so-called targeted cancer drugs and occur in 45–100% of patients. In addition to a characteristic papulo-pustular rash, adverse effects include painful paronychia, xerosis cutis, pruritus, alopecia or alterations of the hair structure. These often stigmatizing side-effects represent a serious threat to the patients‘ quality of life and compliance and may lead to dose-reduction or even cessation of the antineoplastic therapy. Considering the steadily growing numbers of patients who receive EGFR-targeting therapy, these medicament-associated cutaneous adverse effects are becoming increasingly more important in the routine clinical practice of dermatologists and oncologists.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Berater und Vortragstätigkeit für Roche und Merck/Serono.

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Authors and Affiliations

  1. Hautklinik, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    P.A. Gerber, B.A. Buhren, S. Kürle &  B. Homey

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  1. P.A. Gerber
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  2. B.A. Buhren
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  3. S. Kürle
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  4. B. Homey
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Correspondence to B. Homey.

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Gerber, P., Buhren, B., Kürle, S. et al. Therapie mit Inhibitoren des epidermalen Wachstumsfaktorrezeptors. Hautarzt 61, 654–661 (2010). https://doi.org/10.1007/s00105-010-1943-6

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  • DOI: https://doi.org/10.1007/s00105-010-1943-6

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