Rash is a common epidermal growth factor receptor inhibitor–induced toxicity that can impair quality of life and treatment compliance.
We sought to evaluate the efficacy of doxycycline in preventing erlotinib-induced rash (folliculitis) in patients with non-small-cell lung cancer.
This open-label, randomized, prospective, phase II trial was conducted in 147 patients with locally advanced or metastatic non-small-cell lung cancer progressing after first-line chemotherapy, randomized for 4 months with erlotinib alone 150 mg/d per os (control arm) or combined with doxycycline 100 mg/d (doxycycline arm). Incidence and severity of rash, compliance, survival, and safety were assessed.
Baseline characteristics of the 147 patients were well balanced in the intent-to-treat population. Folliculitis occurred in 71% of patients in the doxycycline arm and 81% in the control arm (P = .175). The severity of folliculitis and other skin lesions was lower in the doxycycline arm compared with the control arm. Other adverse events were reported at a similar frequency across arms. There was no significant difference in survival between treatment arms.
The open-label design of the study and the duration of the treatment with doxycycline are limitations.
Doxycycline did not reduce the incidence of erlotinib-induced folliculitis, but significantly reduced its severity.Le texte complet de cet article est disponible en PDF.
Key words : doxycycline, erlotinib, folliculitis, non-small-cell lung cancer, rash
Abbreviations used : AE, CI, CONSORT, CTCAE, CYTAR, DI, ECOG, EGFR, NCI, NSCLC, OS, PFS, QoL, TEAE
| Supported by Roche.
| Disclosure: Dr Deplanque has received research funds from Roche. Mr Vergnenegre has received research funds from Chugai, Boehringer, Lilly, Roche, and AstraZeneca; and is a consultant for MSD, AstraZeneca, and Roche. Mr Souquet has received honoraria from Roche, Lilly, AstraZeneca, Pfizer, and Amgen. Mr Saal is a salaried employee of Roche. Ms Robert is a consultant for BMS, Roche, GSK, Merck, and Novartis. Mr Chosidow is a consultant for Roche. Mr Gervais, Mr Falchero, Mr Chavaillon, Mr Taviot, and Mr Fraboulet have no conflicts of interest to declare.