表皮生长因子受体抑制剂相关的皮肤黏膜不良反应及其防治

Prevention and treatment of mucocutaneous adverse reactions associated with epidermal growth factor receptor inhibitors

表皮生长因子受体(EGFR)在多种恶性肿瘤中存在过表达,使其成为抗肿瘤生物制剂治疗的重要靶点。针对该靶点的表皮生长因子受体抑制剂(EGFRIs)临床上应用较广泛,包括抗EGFR单克隆抗体和酪氨酸激酶抑制剂。接受EGFRIs治疗的部分患者可出现特征性的剂量依赖性皮肤黏膜不良反应,常见类型包括痤疮样皮疹、甲沟炎、皮肤干燥和瘙痒等。这些副作用会导致患者身体、心理的不适,致使抗肿瘤靶向药物剂量调整、方案更换甚至治疗中断。正确识别和处置EGFRIs相关皮肤黏膜不良反应对于肿瘤的三级预防具有重要意义。本文就EGFRI相关皮肤黏膜不良反应的发病机制、各种临床表现及其防治策略进行阐述。

The epidermal growth factor receptor(EGFR)signaling is aberrantly overexpressed in many solid malignancies,making it an important target for anti-cancer biologic agents.Among them,epidermal growth factor receptor inhibitors(EGFRIs),which have been widely used in clinical practice,include anti-EGFR monoclonal antibodies and tyrosine kinase inhibitors.A proportion of patients treated with EGFRIs develop specific,dose-dependent skin toxicity such as papulopustular rash,paronychia,xerosis and itch.These side effects can cause physical and psychosocial discomfort that may result in dose reduction,discontinuance,or replacement of the current EGFRIs treatment.Correct diagnosis and treatment of these skin and mucosal adverse effects associated with EGFRIs is of great significance for the tertiary prevention of malignant tumors.A review on EGFRI-related mucocutaneous adverse reactions is presented here,focusing on the pathogenesis,the various clinical manifestations,the strategies for prevention and treatment of these conditions.