Zosia Piotrowska, MD, Christine Lovly, MD, PhD, and Amanda Cass, PharmD, BCPS, BCOP, discuss the management of paronychia when treating patients with EGFR TKIs.

Zosia Piotrowska, MD, is a clinical researcher and lung cancer medical oncologist, Massachusetts General Hospital Cancer Center. Christine Lovly, MD, PhD, is an associate professor of medicine, Division of Hematology-Oncology, an Ingram associate professor of cancer research, and co-leader of Translational Research and Interventional Oncology Program at Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center. Amanda Cass, PharmD, BCPS, is a clinical pharmacist, the Thoracic Oncology Clinic, Vanderbilt University Medical Center.

Piotrowska, Lovly, and Cass explain typical approaches in the management of paronychia, which can include topical steroids and antiseptics, or warm water and vinegar soaks. Additionally, the involvement of dermatologists and podiatrists can be beneficial. However, if the paronychia reaches grade 2 and beyond, dose reduction or dose interruption of the EGFR TKI is considered, Piotrowska notes.

Moreover, it is important that clinicians are thorough when checking both fingernail and toenail beds of patients, Lovly explains, since paronychia can sometimes be overlooked by patients. It can be helpful to have patients send pictures of their skin and nail toxicities to allow for easier follow-up without traveling to see their clinician.

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Experts Discuss the Management of Paronychia When Treating Patients with EGFR TKIs

Zosia Piotrowska, MD, Christine Lovly, MD, PhD, and Amanda Cass, PharmD, BCPS, BCOP, discuss the safety profile of mobocertinib (Exkivity) in 

 exon 20 insertion mutation–positive advanced non–small cell lung cancer (NSCLC).

Piotrowska, Lovly, and Cass explain that mobocertinib is the only EGFR TKI currently approved for advanced NSCLC harboring 

 exon 20 insertion mutations. A typical adverse effect (AE) associated with EGFR TKIs is diarrhea, including mobocertinib. Approximately 90% of patients who receive mobocertinib experience diarrhea, Piotrowska notes.

The most common AEs of mobocertinib in addition to diarrhea include stomatitis, vomiting, anorexia, weight loss, and rash. More rare toxicities associated with mobocertinib to be aware of include interstitial lung disease/pneumonitis and cardiac toxicity.

Zosia Piotrowska, MD, Christine Lovly, MD, PhD, and Amanda Cass, PharmD, BCPS, BCOP, discuss the safety profile of mobocertinib in EGFR exon 20 insertion mutation–positive advanced non–small cell lung cancer.

Experts Discuss the Safety Profile of Mobocertinib in EGFR Exon 20–Mutated Advanced NSCLC

Zosia Piotrowska, MD, Christine Lovly, MD, PhD, and Amanda Cass, PharmD, BCPS, BCOP discuss common adverse effects (AEs) with EGFR TKIs.

Zosia Piotrowska, MD, is a clinical researcher and lung cancer medical oncologist, Massachusetts General Hospital Cancer Center. Christine Lovly, MD, is an associate professor of medicine, Division of Hematology-Oncology, an Ingram associate professor of Cancer Research, co-leader, the Translational Research and Interventional Oncology Program, Vanderbilt University Medical Center, Vanderbilt Ingram Cancer Center. Amanda Cass, PharmD, BCPS, is a clinical pharmacist, the Thoracic Oncology Clinic, Vanderbilt University Medical Center.

Lovly, Piotrowska, and Cass, explain that the inhibition of 

 wild-type, which is commonly expressed in the skin, mucous membranes, and the gut, can lead to many of the skin toxicities associated with EGFR TKIs.

Moreover, the 3 experts discuss the adverse effects specifically associated with the use of osimertinib (Tagrisso). Osimertinib can lead to nail bed changes, rash, and sun sensitivity. Additionally, it is important to take up-front preventative measures to attempt to mitigate these skin toxicities.

Zosia Piotrowska, MD, Christine Lovly, MD, PhD, and Amanda Cass, PharmD, BCPS, BCOP discuss common adverse effects with EGFR TKIs.

Zosia Piotrowska, MD

Articles

Experts Discuss the Management of Paronychia When Treating Patients with EGFR TKIs

Experts Discuss the Safety Profile of Mobocertinib in EGFR Exon 20–Mutated Advanced NSCLC

Experts Discuss Common AEs With EGFR TKIs