Background: The EGFRIs and TKIs are effective for cancer target therapy, but the acneiform rashes or called inflammatory papulopustular exanthemas are common (50% to 100%). The conventional therapy for EGFRIs/TKIs-induced skin toxicity is steroids and antibiotics, but their effect is still limited. In this study, a modified Chinese herbal medicine Huang Lian Jie Du decoction cream with Yin-Cold (YC) medicine characteristic was investigated for the effect on patients suffering EGFRIs/TKIs-induced skin toxicity.
Methods: The modified Huang Lian Jie Du (mHLJD) decoction cream was made from 10 herbal medicines including 4 major medicines (Huanglian, Huangqin, Huangbo, and Zhizi) in traditional HLJD decoction. Patients with EGFRIs/TKIs-induced skin toxicity were enrolled. Patients were excluded if they also used other cream for the skin toxicity. Skin conditions were follow up every 2 weeks. The patients’ characteristics, the skin toxicities and treatment response were recorded and analyzed after using mHLJD decoction cream for 1~2 months.
Results: The mHLJD decoction cream and its subpackages were stored at 4℃ before use. Thirty-four patients who had grade 1-3 skin toxicities after receiving EGFRIs or TKIs were enrolled. Five patients were withdrawal or excluded, 2 patients with paronychia syndrome had no improvement and were excluded, too. Finally, data from 27 patients were analyzed. The mean grade of rash acneiform was decreased from 2.23 (ranged 1 to 3) to 0.38 (ranged 0 to 1) after mHLJD decoction cream treatment for 1~2 months. And the mean grade of dry skin was decreased from 1.57 (ranged 1 to 2) to 0.77 (ranged 0 to 1). The changes of skin toxicity were significant and no obvious adverse events.
Conclusions: In summary, the mHLJD decoction cream is effective for alleviation of EGFRIs/TKIs-induced skin rash acneiform and dry skin. And mHLJD decoction cream has no effect in patients with paronychia syndrome.
Trial registration: CYCH, CYCH-IRB No. 2019023. Registered 14 May 2019, http://www.cych.org.tw/irbweb/