抗EGFR抗体薬使用患者における皮膚障害に対する多職種連携による早期介入の有用性
「緒言」 上皮成長因子受容体(epidermal growth factor receptor: EGFR)は, がん細胞以外に皮膚の表皮基底層, 外毛根鞘, エクリン腺, 脂腺細胞などに発現しており, 増殖や分化に重要な役割を果たしている. そのため, EGFRの作用が阻害されると, 高頻度で皮膚障害が発生する. EGFR阻害薬による皮膚障害は, 分裂促進因子活性化タンパク質キナーゼ(mitogen-activated protein kinase: MAPK)経路の抑制により, 細胞外シグナル制御キナーゼ(ERK)1/2のリン酸化が抑制され, ケラチノサイトのアポトーシスが誘導されることで...
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| Published in | 医療薬学 Vol. 50; no. 10; pp. 523 - 530 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人日本医療薬学会
10.10.2024
日本医療薬学会 |
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| Online Access | Get full text |
| ISSN | 1346-342X 1882-1499 |
| DOI | 10.5649/jjphcs.50.523 |
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| Abstract | 「緒言」 上皮成長因子受容体(epidermal growth factor receptor: EGFR)は, がん細胞以外に皮膚の表皮基底層, 外毛根鞘, エクリン腺, 脂腺細胞などに発現しており, 増殖や分化に重要な役割を果たしている. そのため, EGFRの作用が阻害されると, 高頻度で皮膚障害が発生する. EGFR阻害薬による皮膚障害は, 分裂促進因子活性化タンパク質キナーゼ(mitogen-activated protein kinase: MAPK)経路の抑制により, 細胞外シグナル制御キナーゼ(ERK)1/2のリン酸化が抑制され, ケラチノサイトのアポトーシスが誘導されることで生じると報告されている. EGFR阻害薬に伴う皮膚障害のなかで, 皮疹は投与後1～4週目と早期に好発し, 顔面や頭部のみならず全身性に発現し, 治療中止および患者のquality of life (QOL)低下の原因となる. |
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| AbstractList | 「緒言」 上皮成長因子受容体(epidermal growth factor receptor: EGFR)は, がん細胞以外に皮膚の表皮基底層, 外毛根鞘, エクリン腺, 脂腺細胞などに発現しており, 増殖や分化に重要な役割を果たしている. そのため, EGFRの作用が阻害されると, 高頻度で皮膚障害が発生する. EGFR阻害薬による皮膚障害は, 分裂促進因子活性化タンパク質キナーゼ(mitogen-activated protein kinase: MAPK)経路の抑制により, 細胞外シグナル制御キナーゼ(ERK)1/2のリン酸化が抑制され, ケラチノサイトのアポトーシスが誘導されることで生じると報告されている. EGFR阻害薬に伴う皮膚障害のなかで, 皮疹は投与後1～4週目と早期に好発し, 顔面や頭部のみならず全身性に発現し, 治療中止および患者のquality of life (QOL)低下の原因となる. |
| Author | 須野, 学 伊藤, 雄大 嶋本, めぐみ 佐野, 尚平 上田, 弘樹 岸部, 美和子 山本, 有紀 杉本, 里実 亀位, 耕平 栩野, 有輝 松原, 和夫 江川, 英毅 平岡, 芹菜 上中, 智香子 中川, 貴之 |
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| References | 11）Bianchini D, Jayanth A, Chua YJ, Cunningham D, Epidermal growth factor receptor inhibitor-related skin toxicity: mechanisms, treatment, and its potential role as a predictive marker, Clin Colorectal Cancer, 2008, 7, 33-43. 14）Hirabatake M, Ikesue H, Yoshino S, Morimoto M, Yamasaki T, Hashida T, Kawakita M, Muroi N, Pharmacist-urologist collaborative management for patients with renal cell carcinoma receiving pazopanib monotherapy, Biol Pharm Bull, 2023, 46, 1065-1071. 10）Wacker B, Nagrani T, Weinberg J, Witt K, Clark G, Cagnoni PJ, Correlation between development of rash and efficacy in patients treated with the epidermal growth factor receptor tyrosine kinase inhibitor erlotinib in two large phase III studies, Clin Cancer Res, 2007, 13, 3913-3921. 9）Jonker DJ, O’Callaghan CJ, Karapetis CS, Zalcberg JR, Tu D, Au HJ, Berry SR, Krahn M, Price T, Simes RJ, Tebbutt NC, van Hazel G, Wierzbicki R, Langer C, Moore MJ, Cetuximab for the treatment of colorectal cancer, N Engl J Med, 2007, 357, 2040-2048. 2）Lacouture ME, Mechanisms of cutaneous toxicities to EGFR inhibitors, Nat Rev Cancer, 2006, 6, 803-812. 4）Sequist LV, Yang JC, Yamamoto N, O’Byrne K, Hirsh V, Mok T, Geater SL, Orlov S, Tsai CM, Boyer M, Su WC, Bennouna J, Kato T, Gorbunova V, Lee KH, Shah R, Massey D, Zazulina V, Shahidi M, Schuler M, Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations, J Clin Oncol, 2013, 31, 3327-3334. 8）Van Cutsem E, Peeters M, Siena S, Humblet Y, Hendlisz A, Neyns B, Canon JL, Van Laethem JL, Maurel J, Richardson G, Wolf M, Amado RG, Open-label phase III trial of panitumumab plus best supportive care compared with best supportive care alone in patients with chemotherapy-refractory metastatic colorectal cancer, J Clin Oncol, 2007, 25, 1658-1664. 6）Lacouture ME, Mitchell EP, Piperdi B, Pillai MV, Shearer H, Iannotti N, Xu F, Yassine M, Skin toxicity evaluation protocol with panitumumab (STEPP), a phase II, open-label, randomized trial evaluating the impact of a pre-emptive skin treatment regimen on skin toxicities and quality of life in patients with metastatic colorectal cancer, J Clin Oncol, 2010, 28, 1351-1357. 1）山本有紀, 上田弘樹, 山本信之, 清原祥夫, 山崎直也, 仁科智裕, 川島 眞, EGFR阻害薬に起因する皮膚障害の治療手引き－皮膚科・腫瘍内科有志コンセンサス会議からの提案－, 臨床医薬, 2016, 32, 941-949. 17）Shemer A, Daniel III CR, Common nail disorders, Clin Dermatol, 2013, 31, 578-586. 12）Vincenzi B, Santini D, Rabitti C, Coppola R, Zobel BB, Trodella L, Tonini G, Cetuximab and irinotecan as third-line therapy in advanced colorectal cancer patients: a single centre phase II trial, Br J Cancer, 2006, 94, 792-797. 5）Mok TS, Wu Y-L, Ahn M-J, Garassino MC, Kim HR, Ramalingam SS, Shepherd FA, He Y, Akamatsu H, Theelen WS, Lee CK, Sebastian M, Templeton A, Mann H, Marotti M, Ghiorghiu S, Papadimitrakopoulou VA; AURA3 Investigators, Osimertinib or platinum-pemetrexed in EGFR T790M-positive lung cancer, N Engl J Med, 2017, 376, 629-640. 3）Lynch Jr TJ, Kim ES, Eaby B, Garey J, West DP, Lacouture ME, Epidermal growth factor receptor inhibitor-associated cutaneous toxicities: an evolving paradigm in clinical management, Oncologist, 2007, 12, 610-621. 7）Kobayashi Y, Komatsu Y, Yuki S, Fukushima H, Sasaki T, Iwanaga I, Uebayashi M, Okuda H, Kusumi T, Miyagishima T, Sogabe S, Tateyama M, Hatanaka K, Tsuji Y, Nakamura M, Konno J, Yamamoto F, Onodera M, Iwai K, Sakata Y, Abe R, Oba K, Sakamoto N, Randomized controlled trial on the skin toxicity of panitumumab in Japanese patients with metastatic colorectal cancer: HGCSG1001 study, J-STEPP, Future Oncol, 2015, 11, 617-627. 13）Orditura M, Vita FD, Galizia G, Lieto E, Vecchione L, Vitiello F, Martinelli E, Ciardiello F, Correlation between efficacy and skin rash occurrence following treatment with the epidermal growth factor receptor inhibitor cetuximab: a single institution retrospective analysis, Oncol Rep, 2009, 21, 1023-1028. 16）Arnold D, Lueza B, Douillard J-Y, Peeters M, Lenz H-J, Venook A, Heinemann V, Van Cutsem E, Pignon J-P, Tabernero J, Cervantes A, Ciardiello F, Prognostic and predictive value of primary tumour side in patients with RAS wild-type metastatic colorectal cancer treated with chemotherapy and EGFR directed antibodies in six randomized trials, Ann Oncol, 2017, 28, 1713-1729. 15）Masago K, Imamichi F, Masuda Y, Ariga N, Fujitomi K, Fukumine Y, Hatakenaka K, Fujita S, Katakami N, Team management of skin rash associated with use of epidermal growth factor receptor-tyrosine kinase inhibitors, Asia Pac J Oncol Nurs, 2018, 5, 430-434. 18）Tanda M, Yamamoto K, Hori T, Nishiguchi H, Yagi M, Shimizu M, Konishi T, Ozaki T, Yoshioka N, Tachihara M, Ito T, Ikushima S, Omura T, Yano I, Association of STAT3, CYP3A5, and ABCG2 polymorphisms with osimertinib-induced adverse events in NSCLC patients, Anticancer Res, 2023, 43, 1775-1783. |
| References_xml | – reference: 9）Jonker DJ, O’Callaghan CJ, Karapetis CS, Zalcberg JR, Tu D, Au HJ, Berry SR, Krahn M, Price T, Simes RJ, Tebbutt NC, van Hazel G, Wierzbicki R, Langer C, Moore MJ, Cetuximab for the treatment of colorectal cancer, N Engl J Med, 2007, 357, 2040-2048. – reference: 11）Bianchini D, Jayanth A, Chua YJ, Cunningham D, Epidermal growth factor receptor inhibitor-related skin toxicity: mechanisms, treatment, and its potential role as a predictive marker, Clin Colorectal Cancer, 2008, 7, 33-43. – reference: 14）Hirabatake M, Ikesue H, Yoshino S, Morimoto M, Yamasaki T, Hashida T, Kawakita M, Muroi N, Pharmacist-urologist collaborative management for patients with renal cell carcinoma receiving pazopanib monotherapy, Biol Pharm Bull, 2023, 46, 1065-1071. – reference: 6）Lacouture ME, Mitchell EP, Piperdi B, Pillai MV, Shearer H, Iannotti N, Xu F, Yassine M, Skin toxicity evaluation protocol with panitumumab (STEPP), a phase II, open-label, randomized trial evaluating the impact of a pre-emptive skin treatment regimen on skin toxicities and quality of life in patients with metastatic colorectal cancer, J Clin Oncol, 2010, 28, 1351-1357. – reference: 7）Kobayashi Y, Komatsu Y, Yuki S, Fukushima H, Sasaki T, Iwanaga I, Uebayashi M, Okuda H, Kusumi T, Miyagishima T, Sogabe S, Tateyama M, Hatanaka K, Tsuji Y, Nakamura M, Konno J, Yamamoto F, Onodera M, Iwai K, Sakata Y, Abe R, Oba K, Sakamoto N, Randomized controlled trial on the skin toxicity of panitumumab in Japanese patients with metastatic colorectal cancer: HGCSG1001 study, J-STEPP, Future Oncol, 2015, 11, 617-627. – reference: 15）Masago K, Imamichi F, Masuda Y, Ariga N, Fujitomi K, Fukumine Y, Hatakenaka K, Fujita S, Katakami N, Team management of skin rash associated with use of epidermal growth factor receptor-tyrosine kinase inhibitors, Asia Pac J Oncol Nurs, 2018, 5, 430-434. – reference: 3）Lynch Jr TJ, Kim ES, Eaby B, Garey J, West DP, Lacouture ME, Epidermal growth factor receptor inhibitor-associated cutaneous toxicities: an evolving paradigm in clinical management, Oncologist, 2007, 12, 610-621. – reference: 12）Vincenzi B, Santini D, Rabitti C, Coppola R, Zobel BB, Trodella L, Tonini G, Cetuximab and irinotecan as third-line therapy in advanced colorectal cancer patients: a single centre phase II trial, Br J Cancer, 2006, 94, 792-797. – reference: 18）Tanda M, Yamamoto K, Hori T, Nishiguchi H, Yagi M, Shimizu M, Konishi T, Ozaki T, Yoshioka N, Tachihara M, Ito T, Ikushima S, Omura T, Yano I, Association of STAT3, CYP3A5, and ABCG2 polymorphisms with osimertinib-induced adverse events in NSCLC patients, Anticancer Res, 2023, 43, 1775-1783. – reference: 16）Arnold D, Lueza B, Douillard J-Y, Peeters M, Lenz H-J, Venook A, Heinemann V, Van Cutsem E, Pignon J-P, Tabernero J, Cervantes A, Ciardiello F, Prognostic and predictive value of primary tumour side in patients with RAS wild-type metastatic colorectal cancer treated with chemotherapy and EGFR directed antibodies in six randomized trials, Ann Oncol, 2017, 28, 1713-1729. – reference: 2）Lacouture ME, Mechanisms of cutaneous toxicities to EGFR inhibitors, Nat Rev Cancer, 2006, 6, 803-812. – reference: 10）Wacker B, Nagrani T, Weinberg J, Witt K, Clark G, Cagnoni PJ, Correlation between development of rash and efficacy in patients treated with the epidermal growth factor receptor tyrosine kinase inhibitor erlotinib in two large phase III studies, Clin Cancer Res, 2007, 13, 3913-3921. – reference: 17）Shemer A, Daniel III CR, Common nail disorders, Clin Dermatol, 2013, 31, 578-586. – reference: 5）Mok TS, Wu Y-L, Ahn M-J, Garassino MC, Kim HR, Ramalingam SS, Shepherd FA, He Y, Akamatsu H, Theelen WS, Lee CK, Sebastian M, Templeton A, Mann H, Marotti M, Ghiorghiu S, Papadimitrakopoulou VA; AURA3 Investigators, Osimertinib or platinum-pemetrexed in EGFR T790M-positive lung cancer, N Engl J Med, 2017, 376, 629-640. – reference: 4）Sequist LV, Yang JC, Yamamoto N, O’Byrne K, Hirsh V, Mok T, Geater SL, Orlov S, Tsai CM, Boyer M, Su WC, Bennouna J, Kato T, Gorbunova V, Lee KH, Shah R, Massey D, Zazulina V, Shahidi M, Schuler M, Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations, J Clin Oncol, 2013, 31, 3327-3334. – reference: 8）Van Cutsem E, Peeters M, Siena S, Humblet Y, Hendlisz A, Neyns B, Canon JL, Van Laethem JL, Maurel J, Richardson G, Wolf M, Amado RG, Open-label phase III trial of panitumumab plus best supportive care compared with best supportive care alone in patients with chemotherapy-refractory metastatic colorectal cancer, J Clin Oncol, 2007, 25, 1658-1664. – reference: 13）Orditura M, Vita FD, Galizia G, Lieto E, Vecchione L, Vitiello F, Martinelli E, Ciardiello F, Correlation between efficacy and skin rash occurrence following treatment with the epidermal growth factor receptor inhibitor cetuximab: a single institution retrospective analysis, Oncol Rep, 2009, 21, 1023-1028. – reference: 1）山本有紀, 上田弘樹, 山本信之, 清原祥夫, 山崎直也, 仁科智裕, 川島 眞, EGFR阻害薬に起因する皮膚障害の治療手引き－皮膚科・腫瘍内科有志コンセンサス会議からの提案－, 臨床医薬, 2016, 32, 941-949. |
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| Title | 抗EGFR抗体薬使用患者における皮膚障害に対する多職種連携による早期介入の有用性 |
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| ispartofPNX | 医療薬学, 2024/10/10, Vol.50(10), pp.523-530 |
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