Advance of the mechanism and treatment options for cutaneous toxicities induced by epidermal growth factor receptor inhibitors

Epidermal growth factor receptor (EGFR) inhibitors include small molecule tyrosine kinase inhibitors and monoclonal antibodies, which play an important role in the targeting therapies of lung cancer and colorectal cancer, etc. Among them, the small molecule tyrosine kinase inhibitors include gefitinib, erlotinib, icotinib, etc, while monoclonal antibodies include cetuximab and panitumumab. The cutaneous toxicities, often described as acne-like rash, were the most common side-effects observed during EGFR targeted treatment. The severe skin toxicity may induce dose reduction or interruption of treatment, and thus reducing the anti-tumor effect. However, there is still no effective treatment for management of skin toxicity. Current clinical trials have evaluated the managements including oral tetracycline drugs, local application of vitamin K cream, local application of tacrolimus, sunscreen and epidermal growth factor gel. In this review, the mechanism of occurrence, the results of the current trails about the treatment for such skin toxicity, and the available expert consensus and guidance are discussed, so as to provide thoughts for the clinical practice.