BI15 AERATE-Lung: management and prophylaxis of epidermal growth factor receptor inhibitor skin adverse events in lung cancer in the UK
Kara Heelan, Alpa Kanji, Rubeta N Matin, Thomas Newsom-Davis, Rachel Powell, Tabitha Achim, Edward Ottley, Joseph Hickey, Mohammed Qasim, Natalie Ng, Adam JanuszewskiAbstract
Guidelines exist for epidermal growth factor receptor inhibitor-related adverse events (AEs) such as acneiform rash and pruritus, but real-world skin toxicity management in lung cancer is poorly described. This study assessed current practice and variation in skin AE management among healthcare professionals in the UK. A cross-sectional Medical Science Liaison-led survey of UK healthcare professionals was conducted and descriptive analyses were performed. The respondents were clinical or medical oncologists (n = 23), specialist nurses (n = 17), cancer pharmacists (n = 10) and dermatologists (n = 10). Prophylactic recommendations for managing skin toxicity included emollients (80%), sunscreen (68%), oral antibiotics (15%) and topical corticosteroids (7%). For facial grade 1 AEs, dermatologists reported more frequent escalation of treatment earlier than oncology teams. Dermatologists prescribed topical corticosteroids in 40%, topical antibiotics in 50% and oral antibiotics in 30% of patients, compared with 14%, 18% and 18% of patients managed by oncologists, respectively. For torso AEs dermatologists were also more proactive, with oncology teams prescribing oral antibiotics for grade 2 torso AEs less often (68%) than dermatologists (100%). Dermatologists adopt a more proactive management approach, prescribing topical corticosteroids at least twice as often and topical antibiotics three times as often for grade 1 facial AEs than oncology teams. Oncology teams tend to use less aggressive treatment for lower-grade skin toxicity, which may delay symptom control. Differences in prophylaxis practice suggest inconsistent patient education and thresholds for escalation. Streamlining recommendations with earlier dermatology involvement and clearer multidisciplinary pathways could improve early intervention and patient experience. Funding for this study was provided by Johnson & Johnson Innovative Medicine.