Adverse skin reactions after targeted drug therapy

  In recent years, molecular targeted therapy for tumors has been increasing in clinical application year by year, playing an increasing therapeutic role and will become the most promising tumor treatment modality in the 21st century.  Data from a phase III clinical trial in Japan showed that for the first-line treatment of patients with NSCLC with EGFR gene mutation: the efficiency of gefitinib group was 72% and that of chemotherapy group was 38%, with p-value less than 0.001, which was statistically different (p<0.001); and the gefitinib group also showed an advantage in pfs. trust study for advanced nsclc after at least one previous standard regimen of radiotherapy advanced nsclc patients with disease progression and unsuitable for chemoradiotherapy were treated with troche with a dcr rate (complete remission + partial remission + stable) of 68% and a 1-year survival rate of 39%. < p=""> By competitively binding to extracellular ligand binding sites with ATP, it blocks the autophosphorylation of intramolecular tyrosine, blocks tyrosine kinase activation, and inhibits EGFR activation, thereby inhibiting cell cycle progression, accelerating apoptosis, inhibiting angiogenesis, and inhibiting tumor cell infiltration and metastasis.  Epidermal growth factor receptor (EGFR) is overexpressed in a variety of tumor cells, such as pancreatic cancer, breast cancer, colon cancer and non-small cell lung cancer, and thus can be used in the treatment of many tumors. Epidermal growth factor receptor EGFR is a class of proteins with tyrosine kinase (TK) activity that is widely distributed in mammalian epithelial cells and is expressed in all squamous carcinoma cells and overexpressed in more than 65% of large cell carcinomas and adenocarcinomas.  The main side effects include skin adverse reactions, fatigue, diarrhea, nausea, vomiting, interstitial pneumonia, etc. The more serious ones are skin adverse reactions.  The adverse skin reactions are: acne-like rash or even pustular papules; nail fungus and nail fracture; hair changes; dry skin; hypersensitivity reaction and mucositis.  Severe skin reactions not only affect patients’ quality of life and prevent them from participating in normal social activities, but may also lead to dose reduction or even discontinuation of targeted drugs, which affects the efficacy of the drugs.  The early BR.21 study found that the appearance of rash was positively correlated with efficacy [3], and the appearance of rash often meant that the treatment was effective, with excellent efficacy and horrible rash in one, so EGFRIs were called the combination of angel and devil.  At present, I have analyzed most of the patients after targeted drug therapy and applied topical Chinese herbal medicine, which has significantly relieved the adverse skin reactions and solved the patient’s “face” problem without stopping the drug.  The patient, an elderly female, had severe itching and redness of the skin after 1 week of oral treatment with a targeted drug, and after scratching, part of the skin became pus and had high fever.  The patient, an elderly female, had severe skin flaking, itching, dry skin and chapping after taking a targeted drug orally for 1 month, which seriously affected her normal life.