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Study Purpose

To investigate the effects of oral minocycline and topical steroid along with skin moisturizer on the incidence of skin effects in patients receiving panitumumab

Intervention Characteristics/Basic Study Process

Data were obtained from a retrospective chart review to compare the outcomes of patients who received prophylactic versus reactive oral minocycline. Patients received either 100 mg minocycline daily preemptively or as treatment for skin disorders. Topical steroid could be administered at any time based on physician discretion. All patients were to perform skin care by using a moisturizer.

Sample Characteristics

N = 38
MEAN AGE = 62.5 years
AGE RANGE = 35–87 years
MALES: 65%, FEMALES: 35%
KEY DISEASE CHARACTERISTICS: Patients with colorectal cancer. Most in the reactive treatment group were receiving panitumumab alone, and most in the prophylactic group were receiving panitumumab and FOLFOX6.

Setting

SITE: Single site
SETTING TYPE: Not specified
LOCATION: Japan

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Study Design

Retrospective cohort comparison

Measurement Instruments/Methods

Common Terminology Criteria for Adverse Events (CTCAE), version 3

Results

The incidence of grade 2 or higher acneiform rash was 44% in the prophylaxis group versus 84.6% in the reactive treatment group (odds ratio = 0.143, p = 0.04). No significant differences existed in incidence of other adverse reactions, including dry skin, pruritus, and paronychia. Incidence of grade 1 skin reactions was higher in the group that received prophylactic minocycline (p = 0.02). No significant differences in tumor response or time to treatment failure were observed.

Conclusions

The findings suggest that the prophylactic use of minocycline in patients receiving panitumumab may be helpful to reduce the incidence of more severe skin reactions.

Limitations

Small sample (< 100)
Risk of bias (no control group)
Risk of bias (no blinding)
Risk of bias (no random assignment)
Unintended interventions or applicable interventions not described that would influence results
The use of topical steroids was at the investigator's discretion. The full components of general skin care were not described.

Nursing Implications

Prophylactic administration of tetracyclines may have some preventive effects in terms of skin toxicities with epidermal growth factor receptor inhibitiors; however, limited evidence exists to demonstrate efficacy. This small study provides limited evidence regarding this. Further well designed studies are needed to identify the efficacy of oral antibiotics and other aspects of skin care that are most beneficial to prevent skin effects from cancer treatment.