Oncology Brothers: Practice-Changing Cancer Discussions Managing Toxicities of EGFR Inhibitors: Afatinib, Amivantamab-Lazertinib, Osimertinib
May 21, 2025
Dr. Gilberto Lopes, a thoracic medical oncologist from the Sylvester Cancer Center, dives into the world of EGFR inhibitors like Afatinib and Osimertinib. He discusses the evolution of these therapies and highlights common side effects, including skin toxicity and diarrhea. Strategies for managing these toxicities are shared to improve patient quality of life. Insights from recent studies reveal new combinations that enhance treatment effects, while emphasizing the importance of proactive care to optimize outcomes.
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Managing Afatinib Toxicities
- Manage Afatinib's diarrhea proactively with antidiarrheals to avoid dose-limiting toxicity.
- Start antibiotics like doxycycline early for skin toxicity and advise strict sun protection and skin care.
EGFR Inhibition Causes Skin Inflammation
- Blocking EGFR causes skin keratinocyte damage and inflammatory cytokine release.
- This inflammation makes the skin prone to bacterial infections, contributing to skin toxicity.
Skin Toxicity Care Tips
- Use sunscreen and avoid hot water to reduce skin toxicity with amivantamab.
- Avoid topical retinoids as they worsen dryness; consider oral retinoids only for severe cases and stop antibiotics first.