Clinical analysis of 76 cases of erlotinib-induced skin rash in the treatment of non-small cell lung cancer

Objective:To evaluate the relationship between erlotinib-induced skin rash and clinical outcome and explore the effective way to prevent skin rash.Methods:The data from 76 non-small cell lung cancer(NSCLC) patients who experienced erlotinib-induced skin rash from Dec 2005 to Sep 2008 were collected.All the patients were confirmed with NSCLC by pathological and cytological examination and received erlotinib 150 mg/d till they had progressive disease or intolerable adverse reaction.The severity of skin rash was recorded and graded according to National Cancer Institute-Common Toxicity Criteria(NCI-CTC).The therapeutic outcome of skin rash was observed.Results:The skin rash develops as early as 3 days after commencement of erlotinib therapy,with median onset at 8 days.Twenty-seven(35.5%) patients experienced grade 1 skin rash,44 patients(57.9%) had grade 2 and 5 cases(6.6%) had grade 3 skin rash.A statistically significant correlation was observed between skin rash and erlotinib therapy.The disease-controlling rate was 63.0% for grade 1 skin rash patients including 5 cases with partial remission and 12 cases with stable disease and 91.8% for grade 2/3 skin rash patients including 32 cases with partial remission and 13 cases with stable disease(P0.05).The median time to progression(TTP) and median overall survival(OS) were prolonged in patients experienced grade 2/3 skin rash compared with those in patients with grade 1 skin rash(TTP:5.1 months vs 9.7 months,P0.01;OS:10.0 months vs 14.6 months,P0.01).The skin rash was alleviated in 60 out of 76 patients(78.9%).Conclusion:Skin rash is a potent surrogate marker of favorable outcome in patients who received erlotinib treatment.It was tolerable to most patients.Appropriate therapy may be useful in decreasing the severity of skin rash.