PMID- 33392769
OWN - NLM
STAT- MEDLINE
DCOM- 20210611
LR  - 20210611
IS  - 1433-7339 (Electronic)
IS  - 0941-4355 (Linking)
VI  - 29
IP  - 7
DP  - 2021 Jul
TI  - Systemic doxycycline for pre-emptive treatment of anti-EGFR-related skin toxicity 
      in patients with metastatic colorectal cancer receiving first-line 
      panitumumab-based therapy: a post hoc analysis of the Valentino study.
PG  - 3971-3980
LID - 10.1007/s00520-020-05972-2 [doi]
AB  - INTRODUCTION: The combination of anti-EGFRs and doublet chemotherapy is 
      considered the optimal upfront option for patients with RAS/BRAF wild-type 
      left-sided metastatic colorectal cancer (mCRC). The prophylactic or reactive 
      treatment with tetracyclines for EGFR inhibitor-induced skin toxicity is 
      currently clinical practice, though non-conclusive results are available. 
      METHODS: We performed a post hoc analysis of the Valentino study that randomized 
      RAS wild-type mCRC patients to two panitumumab-based maintenance regimens after 
      the first-line induction, aimed at assessing the safety and efficacy of the 
      administration of a pre-emptive doxycycline prophylaxis for anti-EGFR-related 
      skin toxicity. We assessed the rate of treatment-related and panitumumab-related 
      adverse events (AEs), treatment intensity, progression-free survival (PFS), and 
      overall survival (OS). RESULTS: A total of 226 patients, out of the 229 enrolled 
      in the Valentino study, were eligible for the analysis. Overall, 143 (63%) and 83 
      (37%) patients received or not the antibiotic prophylaxis for skin toxicity. Any 
      grade and G3/4 panitumumab-related AEs were reported in 89% versus 92% (p = 
      0.650) and 27% versus 27% (p = 1.000) patients who received or not the 
      pre-emptive prophylaxis, respectively. Any grade and G3/4 skin rash occurred in 
      81% versus 90% (p = 0.085) and 27% versus 25% (p = 0.876) patients receiving or 
      not the prophylaxis, respectively. No significant differences in terms of 
      treatment duration, treatment delays or dose reductions, PFS, and OS were 
      observed in the two sub-populations. CONCLUSION: The adequate management of 
      anti-EGFR-related skin toxicity is fundamental to optimize the outcome of mCRC 
      patients, balancing the survival benefit with patients' quality of life, 
      especially in the first-line setting.
FAU - Raimondi, Alessandra
AU  - Raimondi A
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy.
FAU - Corallo, Salvatore
AU  - Corallo S
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy.
FAU - Lonardi, Sara
AU  - Lonardi S
AD  - Medical Oncology Unit 1, Department of Oncology, Istituto Oncologico 
      Veneto-IRCCS, Padua, Italy.
FAU - Antoniotti, Carlotta
AU  - Antoniotti C
AD  - Unit of Medical Oncology, Department of Translational Research and New 
      Technologies in Medicine, Azienda Ospedaliero-Universitaria Pisana, University of 
      Pisa, Pisa, Italy.
FAU - Rimassa, Lorenza
AU  - Rimassa L
AD  - Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical 
      and Research Center, IRCCS, Rozzano, Italy.
AD  - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
FAU - Amatu, Alessio
AU  - Amatu A
AD  - Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy.
FAU - Tampellini, Marco
AU  - Tampellini M
AD  - Department of Oncology, AOU San Luigi di Orbassano, University of Torino, 
      Orbassano, Italy.
FAU - Racca, Patrizia
AU  - Racca P
AD  - Colorectal Cancer Unit, Medical Oncology Division 1, Azienda 
      Ospedaliero-Universitaria Citta della Salute e della Scienza, Turin, Italy.
FAU - Murialdo, Roberto
AU  - Murialdo R
AD  - Department of Internal Medicine, University of Genoa and IRCCS AOU San 
      Martino-IST, Genoa, Italy.
FAU - Clavarezza, Matteo
AU  - Clavarezza M
AD  - Medical Oncology Unit, Ente Ospedaliero Ospedali Galliera, Genoa, Italy.
FAU - Zaniboni, Alberto
AU  - Zaniboni A
AD  - Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy.
FAU - Toscano, Giuseppe
AU  - Toscano G
AD  - Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of 
      Messina, Messina, Italy.
FAU - Tomasello, Gianluca
AU  - Tomasello G
AD  - Medical Oncology Unit, ASST Ospedale di Cremona, Cremona, Italy.
FAU - Petrelli, Fausto
AU  - Petrelli F
AD  - Medical Oncology Unit, Oncology Department, ASST Bergamo Ovest, Treviglio, Italy.
FAU - Antonuzzo, Lorenzo
AU  - Antonuzzo L
AD  - Clinical Oncology Unit, AOU Careggi, Florence, Italy.
AD  - Department of Experimental and Clinical Medicine, University of Florence, 
      Florence, Italy.
FAU - Giordano, Monica
AU  - Giordano M
AD  - Medical Oncology Unit, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy.
FAU - Cinieri, Saverio
AU  - Cinieri S
AD  - Medical Oncology Unit, Ospedale Antonio Perrino, Brindisi, Italy.
FAU - Longarini, Raffaella
AU  - Longarini R
AD  - Medical Oncology Unit, Azienda Ospedaliera San Gerardo, Monza, Italy.
FAU - Niger, Monica
AU  - Niger M
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy.
FAU - Antista, Maria
AU  - Antista M
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy.
FAU - Ambrosini, Margherita
AU  - Ambrosini M
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy.
FAU - Pagani, Filippo
AU  - Pagani F
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy.
FAU - Prisciandaro, Michele
AU  - Prisciandaro M
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy.
AD  - Oncology and Hemato-oncology Department, University of Milan, via Festa del 
      Perdono 7, 20122, Milan, Italy.
FAU - Randon, Giovanni
AU  - Randon G
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy.
FAU - de Braud, Filippo
AU  - de Braud F
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy.
AD  - Oncology and Hemato-oncology Department, University of Milan, via Festa del 
      Perdono 7, 20122, Milan, Italy.
FAU - Di Bartolomeo, Maria
AU  - Di Bartolomeo M
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy.
FAU - Pietrantonio, Filippo
AU  - Pietrantonio F
AUID- ORCID: 0000-0002-8530-8420
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy. 
      filippo.pietrantonio@istitutotumori.mi.it.
AD  - Oncology and Hemato-oncology Department, University of Milan, via Festa del 
      Perdono 7, 20122, Milan, Italy. filippo.pietrantonio@istitutotumori.mi.it.
FAU - Morano, Federica
AU  - Morano F
AD  - Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 
      via Giacomo Venezian 1, 20133, Milan, Italy.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20210103
PL  - Germany
TA  - Support Care Cancer
JT  - Supportive care in cancer : official journal of the Multinational Association of 
      Supportive Care in Cancer
JID - 9302957
RN  - 6A901E312A (Panitumumab)
RN  - N12000U13O (Doxycycline)
SB  - IM
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/pharmacology/*therapeutic use
MH  - Colorectal Neoplasms/*drug therapy
MH  - Doxycycline/pharmacology/*therapeutic use
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Metastasis
MH  - Panitumumab/pharmacology/*therapeutic use
MH  - Skin Diseases/*chemically induced
OTO - NOTNLM
OT  - Adverse events
OT  - Colorectal cancer
OT  - EGFR inhibitor
OT  - Metastasis
OT  - Skin rash
OT  - Tetracyclines
EDAT- 2021/01/05 06:00
MHDA- 2021/06/12 06:00
CRDT- 2021/01/04 05:33
PHST- 2020/10/08 00:00 [received]
PHST- 2020/12/22 00:00 [accepted]
PHST- 2021/01/05 06:00 [pubmed]
PHST- 2021/06/12 06:00 [medline]
PHST- 2021/01/04 05:33 [entrez]
AID - 10.1007/s00520-020-05972-2 [pii]
AID - 10.1007/s00520-020-05972-2 [doi]
PST - ppublish
SO  - Support Care Cancer. 2021 Jul;29(7):3971-3980. doi: 10.1007/s00520-020-05972-2. 
      Epub 2021 Jan 3.