ID #553 An evidence-based cutaneous assessment tool for patients treated with targeted therapies
Ashley Meyer, Andrew Crow, Allison Galkowski, , Micah Higgins, Marylynne Strachan, Michele McHugh, Andrea Ogle, Concetta DiDomenico, Cynthia Schmus, Corrine Hoeppner, Kaaren Waters, Anastasia BrownAbstract
Background
Targeted therapies, including mitogen-activated protein kinase (MAPK) pathway and epidermal growth factor receptor (EGFR) inhibitors, offer innovative treatment options but frequently cause cutaneous toxicities affecting the skin, oral mucosa, hair and nails. These cutaneous toxicities vary widely and may be specific to individual inhibitors or the combination of, creating challenges in recognition and accurate diagnosis which can delay appropriate management. Therefore, educating both patients and healthcare providers on expected toxicities and available treatment strategies is essential.
Methods
A systematic literature review was conducted to define the most common cutaneous toxicities of MAPK and EGFR inhibitors and to then evaluate evidence-based management strategies. Searches were completed in both PubMed and Cochrane Library for relevant articles published between 1/1/2002 and 7/21/2025. Therapies included MEK, BRAF, EGFR, and pan-RAF inhibitors. Combination therapy was limited to BRAF and MEK inhibitors. The search initially produced 748 references which were narrowed to 394 based upon subject and keyword relevance. Two team members then blindly reviewed all abstracts and filtered them based on inclusion and exclusion criteria.
Results
The 175 full-text articles (90 EGFR, 44 BRAF, 37 MEK, and 4 pan-RAF) were reviewed and evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation criteria (GRADE). Cutaneous toxicities were among the most frequently reported and varied based on targeted therapy classes. Comprehensive assessment guidelines and diagrams were created for each targeted therapy included in the literature review. Evidence-based management recommendations were developed.
Conclusion
The formation of evidence-based comprehensive tools will ensure that patients on targeted therapies are appropriately screened, facilitating early identification and management of toxicities while improving patient experience.