affects of tarceva on skin

[angkazoo]

Hello-

I was wondering if you know much about the drug Tarceva? I took it as part of a clinical trial to see if it interacted with a tumor located in my mouth. After three days of the medication (150 mg/day) I developed a rare-severe rash that the doctors had not seen or read of.  It covered my torso, face, scalp, and back. Some bumps were just red while others were tiny pustules located very close to the top of my skin.  They easily popped and reformed when I brushed my face with a wet towel.  

It has been about three weeks since I stopped the drug and the majority of the rash has subsided. I now have some pink-purple discoloration on my back, breasts, and face. As well as increased oil on my face and some grouping of tiny pimples. Before I hardly had any pimples.  

I am using clyndamicine twice a day and taking an antibiotic for post op reasons.  Have you come across any cases of rashes caused by Tarceva and further treatment?  Or do you have any recommendations for what to do? My next dermatology appointment is not until September but I feel like there should be something more my team should be doing.  

[BhumikaMD]

Hi,

'Rash occurs in the majority of patients. This resembles acne and primarily involves the face and neck. It is self-limited and resolves in the majority of cases, even with continued use. Interestingly, some clinical studies have indicated a correlation between the severity of the skin reactions and increased survival though this has not been quantatively assessed.

The Journal of Clinical Oncology reported in 2004 that "cutaneous [skin] rash seems to be a surrogate marker of clinical benefit, but this finding should be confirmed in ongoing and future studies."

The newsletter Lung Cancer Frontiers reported in its October 2003 issue, "Patients with moderate to severe cutaneous reactions [rashes] have a far better survival, than those with only mild reactions and much better than those with no cutaneous manifestations of drug effects."

http://en.wikipedia.org/wiki/Erlotinib

Let us know if you need any other information.

Regards.

[Dr Smitha Mathews]

Hi,

Skin rashes and dry skin are a common side effect of Tarceva.
They have been reported in over 10% of patients who have used Tarceva.

In view of the fact that the skin eruptions were caused by a particular drug that has been discontinued and that the eruptions appear to be subsiding, minimal intervention would be necessary to clear up your skin.

Ensure that you use a sunscreen which is gentle and nonirritating and does not interact with the other medications you are on.
Use soap over the lesions only once a day. At other times just splash water and pat dry. Skin will restore the normal oil levels by itself.

If not interacting with the other medications you are on, you can apply a mild steroid preparation over the rashes, only at night.
However, steroid use concurrent with antineoplastic medications is not advisable.

Do keep us posted on your doubts and progress.
regards