Why Do Skin Changes Occur
Skin changes are caused by the way some targeted therapy drugs work. For instance, some targeted drugs attack the epidermal growth factor receptor protein, which tells the cancer cells to grow and divide. These are called EGFR inhibitors, and examples are cetuximab , panitumumab , and erlotinib . The problem is that normal skin cells also have a lot of EGFR, so drugs that target or block EGFR can affect skin cells, too. They turn off the signal for skin cells to grow normally and make it harder for them to retain moisture.
Drugs called angiogenesis inhibitors often target vascular endothelial growth factor proteins. Bevacizumab is one of these drugs. The VEGF proteins help tumors build and keep a blood supply, but they also seem to be important to the very small blood vessels in the hands and feet. Blocking these proteins leads to damage in these tiny blood vessels which can cause hand-foot syndrome .
What Is Targeted Therapy
Targeted therapy is a treatment that targets the specific genes, proteins, or the tissue environment that contributes to cancer growth and development. Some targeted therapies can cause specific side effects to the skin, hair, and nails. These side effects are caused by the effect of medications on the healthy growth of these tissues.
Targeted therapies that may cause skin problems
The following are some of the types of targeted therapies that may affect the skin. If your doctor prescribes a targeted therapy, ask what side effects to expect and how they will be treated.
Your health care team can help you manage these side effects so treatment can continue. Managing these side effects can also help avoid major changes to your skin, hair, and nails. It is important to note that the skin side effects linked with these drugs are not allergic reactions or infections.
Common skin-related side effects of specific targeted drugs
Below is a list of common targeted therapy drugs that can cause skin related problems.
Afatinib , cetuximab , erlotinib , gefitinib , osimertinib , and panitumumab . These drugs may be prescribed for colorectal cancer, head and neck cancer, lung cancer, and pancreatic cancer. Skin-related side effects include:
Acne-like rash on face and upper body
Inflammation around fingernails
What Should I Know About Side Effects
- Not every person gets every side effect, and some people get few or none.
- How severe a side effect might be can vary greatly from drug to drug and from person to person. Be sure to talk to your cancer care team about which side effects are most common with your treatment, how long they might last, how bad they might be, and when you should call the doctors office about them. Your doctor may give you instructions to follow or medicines to help prevent some side effects before they happen.
- Rare and unusual side effects can happen with some of these drugs, and some can be serious. Report all changes and side effects as soon as possible to your cancer care team.
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What Are The Advantages Of Osimertinib
- Exhaustion, trouble breathing and insomnia: According to preliminary estimates, osimertinib led to a greater improvement in these symptoms during the course of the study than the standard treatment did.
- Nausea, vomiting and loss of hair: The study suggests that osimertinib has an advantage over combined chemotherapy in terms of these symptoms as well.
- Health-related quality of life: The study also suggests that osimertinib has an advantage regarding some aspects of quality of life, including:
- Physical functioning: Compared to patients who had the standard treatment, those who had treatment with osimertinib were better able to manage everyday activities such as grocery shopping, eating or doing the laundry.
- Role functioning: Compared to patients who received cisplatin and pemetrexed, those who had treatment with osimertinib felt less restricted by their disease in their everyday life, social activities or work.
- Social functioning: Compared to those who had combined chemotherapy, the patients who took osimertinib felt less limited in activities with their family and friends, and other social activities.
Fingernail And Toenail Redness Swelling And Tenderness
- You may develop redness, swelling, and tenderness around 1 or more of your fingernails or toenails.
- The symptoms vary in how severe they are. They may make it hard for you to pick up small things such as a pen or a fork. You may have trouble buttoning your clothes or putting on shoes.
- Lesions may form around your nails that bleed easily and look like an ingrown nail. They can become infected. To prevent infection:
- Try vinegar soaks. This is done by mixing equal amounts of white distilled vinegar and cool tap water. Soak lesions in the mixture for 15 minutes, 1 to 2 times every day.
- Apply over-the-counter povidone iodine 10% to lesions using a Q-Tip, and cover with a Band-Aid.
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Common Symptoms For These People *:
* Approximation only. Some reports may have incomplete information.
Some Patients Did Not Report Hair Loss Before Treatment:
For patients that did not report Hair Loss before treatment, Figure 3 shows the percentage of patients reporting if they had Hair Loss between weeks 1 and 24.
Figure 3. Patient-Reported Hair Loss During the First 24 Weeks on Treatment: Patients Without Hair Loss Before Treatment
All responses from patients who did not report Hair Loss before treatment were included in the analysis. Some patients did not report their symptoms every week, therefore the number of patients may vary between weeks. Furthermore, not all patients remained on the treatment for 24 weeks which is a reason for the change in the number of patients over the course of treatment.
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How Should I Use This Medication
The recommended dose of this medication for adults is 80 mg taken by mouth once a day.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
Osimertinib may be taken with food or on an empty stomach however, it should be taken the same way, at approximately the same time, every day. Swallow this medication whole with water. Do not crush, split, or chew the tablet.
If you are unable to swallow the tablet whole, it may be dropped into 50 mL of non-carbonated, room temperature water immediately before taking the dose. Stir the water and tablet until the tablet has dissolved and then immediately swallow the water containing the dissolved tablet. Rinse the cup with another 50 mL of water and drink the water that was used to rinse the cup. This will ensure that you get all the medication that was left in the cup.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Is It Safe To Take Tagrisso If You Are Pregnant
Osimertinib can harm an unborn baby if the mother or the father is using this medicine. If you are a woman, do not use Tagrisso if you are pregnant. You may need to have a negative pregnancy test before starting this treatment.
Tagrisso is a cancer medicine that interferes with the growth and spread of cancer cells in the body.
Tagrisso is used to treat a certain type of non-small cell lung cancer. Osimertinib is used only if your tumor has a specific genetic marker, for which your doctor will test. Tagrisso is usually given after other treatments have failed.
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When Cancer Had Spread To The Brain
41 people who had tumors spread to the brain before the study were evaluated. 22 of them were treated with TAGRISSO and 19 were treated with gefitinib or erlotinib to see how it affected their brain tumors. The study found:
- 77% of those taking TAGRISSO saw their brain tumors shrink. 18% saw their brain tumors completely disappear
- 63% of those treated with other EGFR-targeted therapies, erlotinib or gefitinib, saw their brain tumors shrink. No one saw their tumors completely disappear
AstraZeneca may be able to help you access the medicine you need.
Cancer that started in the lungs and has spread to other parts of the body such as the liver or brain. Often referred to as stage 4 cancer.
One of two main types of lung cancer. NSCLC is more common.
A protein found on the surface of some cells. When EGFR mutates, it plays a role in causing cancer cells to grow excessively and spread as tumors. EGFR is one of the stage 4 NSCLC biomarkers.
An abnormal growth of cells that may be benign or malignant .
The middle number in a group of numbers arranged from lowest to highest.
A disease in which abnormal cells divide out of control, at a very fast rate. These abnormal cells can spread to other nearby organs and tissues.
An abnormal growth of cells that may be benign or malignant .
A gene carries information about traits passed from parent to child. Most contain instructions for making a specific protein.
Important Safety Information
TAGRISSO may cause serious side effects, including:
Side Effects Not Requiring Immediate Medical Attention
Some side effects of osimertinib may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- skin rash or dryness of the skin
- swelling or inflammation of the mouth
Applies to osimertinib: oral tablet
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More Common Side Effects Of Tagrisso
Tagrisso can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are some of the more common side effects reported by people who took Tagrisso in clinical trials:
- low levels of:
- hair loss
These side effects may be temporary, lasting a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Tagrisso and want to tell the FDA about it, visit MedWatch.
* For more information about this side effect, see Side effect specifics below.
What Other Drugs Could Interact With This Medication
There may be an interaction between osimertinib and any of the following:
- 5-ASA medications
- tricyclic antidepressants
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter , and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Tagrisso
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Can Skin Changes Be Prevented
There are things you can do to help prevent skin changes or at least try to keep them under control. Your doctor may ask you to start doing these things as soon as targeted treatment starts before you have skin problems.
Starting good skin care before you have side effects may help to minimize the problems You may be asked to:
Ask your doctor or nurse if there are other things you can do to help lower your chance of skin problems.
Side Effects Requiring Immediate Medical Attention
Along with its needed effects, osimertinib may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking osimertinib:
- fast, pounding, or uneven heartbeat
- pain in the chest, groin, or legs, especially the calves
- pain, redness, or swelling in the arm or leg
- slurred speech
- sudden, severe weakness or numbness in the arm or leg
- trouble breathing
- general feeling of discomfort or illness
- inability to speak
- sudden, severe weakness on one side of the body
- temporary blindness
- Eye redness, irritation, or pain
Incidence not known
- red skin lesions, often with a purple center
- sore throat
- sores, ulcers, or white spots in the mouth or on the lips
- unusual tiredness or weakness
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Why Do People Lose Hair From Cancer Treatments
Chemotherapy drugs work by targeting rapidly dividing cells, such as cancer cells. Because chemotherapy drugs attack all cells that are dividing quickly, they affect cancer cells as well as normal cells that divide quickly, such as cells in the bone marrow, the lining of the mouth and intestines, and hair follicles.2
Other cancer treatments that may cause hair loss include radiation therapy and some targeted therapies. Radiation therapy, the use of radiation beams to kill cancer cells, can cause hair loss at the location where it is directed on the body. Targeted therapies help block the growth or slow the spread of cancer by interfering with specific molecules that are involved in the cancer cells growth processes. Some targeted therapies can affect the hair cells as well as cancer cells, possibly causing hair thinning or hair loss. Patients should talk to their doctor or nurse about the specific treatment they are receiving and what to expect with side effects.1,3