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| Name | Class |
|---|---|
| GlaxoSmithKline | INDUSTRY |
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The purpose of this study is to characterize the microscopic findings of skin rash associated with the use of chemotherapeutic anticancer agents known as epidermal growth factor inhibitors (EGFRIs).
Epidermal growth factor (EGF) and its receptor, the EGFR, are known to be key drivers in cellular proliferation and survival. Malignant tumors result from uncontrolled cell proliferation. The use of drugs which target the EGF receptor has offered patients with non-small cell lung cancer, pancreatic cancer, head and neck cancer, and colorectal cancer additional targeted anti-cancer therapy in addition to their chemotherapeutic regimens. As a result of increased use of these EGFR inhibitors, adverse events have emerged involving the skin, hair, nails and eyes. While the EGFR inhibitors block the signal transduction that interfere with cellular proliferation and survival of cancerous cells, they also affect the normal EGF function in the skin (papulopustular rash), hair, and nails. In this study, we seek to histologically characterize the papulopustular rash in patients who have been treated with lapatinib and compare our findings with those associated with three other EGFRIs, cetuximab, erlotinib and panitumumab.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| L | Patients treated with lapatinib who developed skin toxicities and have been biopsied for skin rash. |
| |
| C | Patients treated with cetuximab who developed skin toxicities and have been biopsied for skin rash. |
| |
| P | Patients treated with panitumumab who developed skin toxicities and have been biopsied for skin rash. |
| |
| E | Patients treated with erlotinib who developed skin toxicities and have been biopsied for a skin rash. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Skin Biopsy of Skin Rash Secondary to EGFRI Use | Procedure | Patients who were treated with lapatinib, cetuximab, panitumumab or erlotinib who subsequently developed a skin rash have been biopsied as standard of care. The biopsies will be used for this study. |
| Measure | Description | Time Frame |
|---|---|---|
| Differences in Histologic Alterations in Rash Caused by Lapatinib, a Dual HER1/2 Inhibitor (HER1/2i), and the Single HER1 Inhibitors (HER1i) Cetuximab, Erlotinib,and Panitumumab. | 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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Patients selected for this study were treated with lapatinib, erlotinib, panitumumab or cetuximab, developed skin toxicities and were biopsied as standard of care for skin rash at the Department of Dermatology, Northwestern University.
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| Name | Affiliation | Role |
|---|---|---|
| Mario Lacouture, MD | Northwestern University, Department of Dermatology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Northwestern University | Chicago | Illinois | 60611 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 11397665 | Background | Gullick WJ. The Type 1 growth factor receptors and their ligands considered as a complex system. Endocr Relat Cancer. 2001 Jun;8(2):75-82. doi: 10.1677/erc.0.0080075. | |
| 14967450 | Background | Marmor MD, Skaria KB, Yarden Y. Signal transduction and oncogenesis by ErbB/HER receptors. Int J Radiat Oncol Biol Phys. 2004 Mar 1;58(3):903-13. doi: 10.1016/j.ijrobp.2003.06.002. |
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A total of 8 samples per patient/inhibitor were collected, with a total of 32 patient specimens analyzed for this study.
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| ID | Title | Description |
|---|---|---|
| FG000 | Patients Treated With Lapatinib (L) | Patients treated with lapatinib who developed skin toxicities and have been biopsied for skin rash. |
| FG001 | Patients Treated With Cetuximab (C) | Patients treated with cetuximab who developed skin toxicities and have been biopsied for skin rash. |
| FG002 | Patients Treated With Panitumumab (P) | Patients treated with panitumumab who developed skin toxicities and have been biopsied for skin rash. |
| FG003 | Patients Treated With Erlotinib (E) | Patients treated with erlotinib who developed skin toxicities and have been biopsied for a skin rash. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Patients Treated With Lapatinib (L) | Patients treated with lapatinib who developed skin toxicities and have been biopsied for skin rash. |
| BG001 | Patients Treated With Cetuximab (C) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Differences in Histologic Alterations in Rash Caused by Lapatinib, a Dual HER1/2 Inhibitor (HER1/2i), and the Single HER1 Inhibitors (HER1i) Cetuximab, Erlotinib,and Panitumumab. | Posted | Number | Total number of cases | 6 months |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Patients Treated With Lapatinib (L) | Patients treated with lapatinib who developed skin toxicities and have been biopsied for skin rash. |
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Small sample size
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Mario Lacouture, MD | Northwestern University | 212-610-0079 | LacoutuM@mskcc.org |
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| ID | Term |
|---|---|
| D005076 | Exanthema |
| ID | Term |
|---|---|
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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Skin tissue biopsies.
| 11057895 | Background | Schlessinger J. Cell signaling by receptor tyrosine kinases. Cell. 2000 Oct 13;103(2):211-25. doi: 10.1016/s0092-8674(00)00114-8. No abstract available. |
| 15992698 | Background | Robert C, Soria JC, Spatz A, Le Cesne A, Malka D, Pautier P, Wechsler J, Lhomme C, Escudier B, Boige V, Armand JP, Le Chevalier T. Cutaneous side-effects of kinase inhibitors and blocking antibodies. Lancet Oncol. 2005 Jul;6(7):491-500. doi: 10.1016/S1470-2045(05)70243-6. |
| 11972157 | Background | Fuchs E, Raghavan S. Getting under the skin of epidermal morphogenesis. Nat Rev Genet. 2002 Mar;3(3):199-209. doi: 10.1038/nrg758. |
| 16990857 | Background | Lacouture ME. Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer. 2006 Oct;6(10):803-12. doi: 10.1038/nrc1970. |
| 11056418 | Background | Jost M, Kari C, Rodeck U. The EGF receptor - an essential regulator of multiple epidermal functions. Eur J Dermatol. 2000 Oct-Nov;10(7):505-10. |
| 9044042 | Background | Rodeck U, Jost M, Kari C, Shih DT, Lavker RM, Ewert DL, Jensen PJ. EGF-R dependent regulation of keratinocyte survival. J Cell Sci. 1997 Jan;110 ( Pt 2):113-21. doi: 10.1242/jcs.110.2.113. |
| 9406816 | Background | Peus D, Hamacher L, Pittelkow MR. EGF-receptor tyrosine kinase inhibition induces keratinocyte growth arrest and terminal differentiation. J Invest Dermatol. 1997 Dec;109(6):751-6. doi: 10.1111/1523-1747.ep12340759. |
| 9790496 | Background | Hauser PJ, Agrawal D, Hackney J, Pledger WJ. STAT3 activation accompanies keratinocyte differentiation. Cell Growth Differ. 1998 Oct;9(10):847-55. |
| 15258446 | Background | Mimeault M, Bonenfant D, Batra SK. New advances on the functions of epidermal growth factor receptor and ceramides in skin cell differentiation, disorders and cancers. Skin Pharmacol Physiol. 2004 Jul-Aug;17(4):153-66. doi: 10.1159/000078818. |
| 15827339 | Background | Woodworth CD, Michael E, Marker D, Allen S, Smith L, Nees M. Inhibition of the epidermal growth factor receptor increases expression of genes that stimulate inflammation, apoptosis, and cell attachment. Mol Cancer Ther. 2005 Apr;4(4):650-8. doi: 10.1158/1535-7163.MCT-04-0238. |
| 15205458 | Background | Lorch JH, Klessner J, Park JK, Getsios S, Wu YL, Stack MS, Green KJ. Epidermal growth factor receptor inhibition promotes desmosome assembly and strengthens intercellular adhesion in squamous cell carcinoma cells. J Biol Chem. 2004 Aug 27;279(35):37191-200. doi: 10.1074/jbc.M405123200. Epub 2004 Jun 16. |
| 15814736 | Background | Pastore S, Mascia F, Mariotti F, Dattilo C, Mariani V, Girolomoni G. ERK1/2 regulates epidermal chemokine expression and skin inflammation. J Immunol. 2005 Apr 15;174(8):5047-56. doi: 10.4049/jimmunol.174.8.5047. |
| 8552187 | Background | Fisher GJ, Datta SC, Talwar HS, Wang ZQ, Varani J, Kang S, Voorhees JJ. Molecular basis of sun-induced premature skin ageing and retinoid antagonism. Nature. 1996 Jan 25;379(6563):335-9. doi: 10.1038/379335a0. |
| 16123117 | Background | El-Abaseri TB, Putta S, Hansen LA. Ultraviolet irradiation induces keratinocyte proliferation and epidermal hyperplasia through the activation of the epidermal growth factor receptor. Carcinogenesis. 2006 Feb;27(2):225-31. doi: 10.1093/carcin/bgi220. Epub 2005 Aug 25. |
| 17110623 | Background | Moy B, Goss PE. Lapatinib: current status and future directions in breast cancer. Oncologist. 2006 Nov-Dec;11(10):1047-57. doi: 10.1634/theoncologist.11-10-1047. |
| 11773160 | Background | Albanell J, Rojo F, Averbuch S, Feyereislova A, Mascaro JM, Herbst R, LoRusso P, Rischin D, Sauleda S, Gee J, Nicholson RI, Baselga J. Pharmacodynamic studies of the epidermal growth factor receptor inhibitor ZD1839 in skin from cancer patients: histopathologic and molecular consequences of receptor inhibition. J Clin Oncol. 2002 Jan 1;20(1):110-24. doi: 10.1200/JCO.2002.20.1.110. |
| 10702262 | Background | Busse D, Doughty RS, Ramsey TT, Russell WE, Price JO, Flanagan WM, Shawver LK, Arteaga CL. Reversible G(1) arrest induced by inhibition of the epidermal growth factor receptor tyrosine kinase requires up-regulation of p27(KIP1) independent of MAPK activity. J Biol Chem. 2000 Mar 10;275(10):6987-95. doi: 10.1074/jbc.275.10.6987. |
| 15851793 | Background | Perez-Soler R, Delord JP, Halpern A, Kelly K, Krueger J, Sureda BM, von Pawel J, Temel J, Siena S, Soulieres D, Saltz L, Leyden J. HER1/EGFR inhibitor-associated rash: future directions for management and investigation outcomes from the HER1/EGFR inhibitor rash management forum. Oncologist. 2005 May;10(5):345-56. doi: 10.1634/theoncologist.10-5-345. |
| 16286741 | Background | Molinari E, De Quatrebarbes J, Andre T, Aractingi S. Cetuximab-induced acne. Dermatology. 2005;211(4):330-3. doi: 10.1159/000088502. |
| 16418322 | Background | Nelson MH, Dolder CR. Lapatinib: a novel dual tyrosine kinase inhibitor with activity in solid tumors. Ann Pharmacother. 2006 Feb;40(2):261-9. doi: 10.1345/aph.1G387. Epub 2006 Jan 17. |
| 17679920 | Background | Cameron D. Lapatinib plus capecitabine in patients with HER2-positive advanced breast cancer. Clin Adv Hematol Oncol. 2007 Jun;5(6):456-8. No abstract available. |
| 20732960 | Result | Nardone B, Nicholson K, Newman M, Guitart J, Gerami P, Talarico N, Yang XJ, Rademaker A, West DP, Lacouture ME. Histopathologic and immunohistochemical characterization of rash to human epidermal growth factor receptor 1 (HER1) and HER1/2 inhibitors in cancer patients. Clin Cancer Res. 2010 Sep 1;16(17):4452-60. doi: 10.1158/1078-0432.CCR-10-0421. Epub 2010 Aug 23. |
Patients treated with cetuximab who developed skin toxicities and have been biopsied for skin rash.
| BG002 | Patients Treated With Panitumumab (P) | Patients treated with panitumumab who developed skin toxicities and have been biopsied for skin rash. |
| BG003 | Patients Treated With Erlotinib (E) | Patients treated with erlotinib who developed skin toxicities and have been biopsied for a skin rash. |
| BG004 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
Patients treated with panitumumab who developed skin toxicities and have been biopsied for skin rash. |
| OG003 | Patients Treated With Erlotinib (E) | Patients treated with erlotinib who developed skin toxicities and have been biopsied for a skin rash. |
|
|
| 0 |
| 8 |
| 0 |
| 8 |
| EG001 | Patients Treated With Cetuximab (C) | Patients treated with cetuximab who developed skin toxicities and have been biopsied for skin rash. | 0 | 8 | 0 | 8 |
| EG002 | Patients Treated With Panitumumab (P) | Patients treated with panitumumab who developed skin toxicities and have been biopsied for skin rash. | 0 | 8 | 0 | 8 |
| EG003 | Patients Treated With Erlotinib (E) | Patients treated with erlotinib who developed skin toxicities and have been biopsied for a skin rash. | 0 | 8 | 0 | 8 |
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