Survey analyses management of patients suffering from EGFRI toxicities

A recent survey of nurses from seven European countries, published in the peer-reviewed journal ecancermedicalscience, has analysed the management of patients suffering from toxicities due to treatment with epidermal growth factor receptor inhibitors (EGFRI).

Stimulation of epidermal growth factor receptors (EGFR) occurs in a number of types of cancer, including head and neck, colorectal, pancreatic, and non-small cell lung cancer.

For this reason, inhibitors of this protein are becoming a common treatment for these types of cancers. Unfortunately, a side effect of this treatment is toxicity to several types of epithelial cells which also express high levels of EGFRs, including hair follicles, sebaceous glands, mucosal tissues, and ocular
tissues.

Typical side effects of EGFRI treatment include skin rashes, dry skin, fissures (cracked skin), paronychia (bacterial infection of the cuticle) and pyogenic granuloma (capillary haemangioma). The majority of these side effects are treatable with topical creams or oral medication but there is no standardised procedure established between European countries concerning the treatment of cancer patients with such side effects.

In an attempt to assess the similarities and differences in procedures, Liesbeth Lemmens from University Hospitals Leuven, Gasthuisberg in Belgium, surveyed seven nurses from hospitals in Belgium, Ireland, the Netherlands, Spain, Sweden, Switzerland and the United Kingdom. It was found that the management of EGFRI toxicities differed substantially between the nurses surveyed. This result may be expected since different types of EGFRIs, with different toxicity profiles, are used throughout Europe and there are a number of different treatment options available for these conditions.

However, it is stated that standardised guidelines between European countries should improve patient care and may also be a useful resource for clinicians throughout Europe. In addition, standardised guidelines should focus on more information regarding patient education on lifestyle modifications, early symptoms of toxicity as well as regular patient assessment.

Lemmens concludes the article with the acknowledgement that the current work is an exploratory survey and is not necessarily representative of the entire European Union or of all hospitals within each country. However, the results from this survey can be used as a starting point for a more in-depth survey including a larger number of European countries.