Opinion

Video

Balancing Treatment and Quality of Life: Adverse Events of First-Line Agents in NSCLC

A panelist discusses how EGFR tyrosine kinase inhibitors (TKIs) commonly cause dermatologic toxicities (including acneiform rash, dry skin, photosensitivity, and paronychia) and diarrhea, which can significantly impact patients’ quality of life by causing physical discomfort, affecting appearance, and limiting daily activities.

Adverse Events of EGFR TKIs: Summary for Physicians

Based on the transcript, the most common adverse events associated with EGFR TKIs are:

Dermatologic Toxicities

  • Acneiform rash: Typically affects face, upper chest, back, and shoulders
  • More common in men than in women

  • Can range from mild to severe with potential for superimposed infection

  • Management varies by grade/body surface area affected

  • Severe cases may require topical and oral antibiotics
  • Dry skin: Requires regular moisturizing with creamy products
  • Associated itching can disrupt sleep and impact quality of life
  • Paronychia: Presentations include nail flaking, cracking, nail bed/cuticle inflammation
  • Can progress to abscess formation and nail loss in severe cases

  • Management options include vinegar soaks and dermatology referral
  • Photosensitivity: Increased skin sensitivity to sunlight

Gastrointestinal Effects

  • Diarrhea: Second most common adverse event
  • Ranges from increased frequency with formed stool to loose/watery diarrhea

  • Associated urgency significantly impacts quality of life

  • Patients may limit activities due to unpredictability

Quality-of-Life Impact

  • Dermatologic toxicities may cause embarrassment, leading to social isolation
  • Diarrhea can restrict patients’ ability to leave home
  • Both categories of adverse effects may necessitate dose adjustments

This summary highlights the importance of proactive symptom management to maintain treatment efficacy and patient quality of life.

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