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Mihai MM, Ion A, Giurcăneanu C, et al. The Impact of Long-Term Antibiotic Therapy of Cutaneous Adverse Reactions to EGFR Inhibitors in Colorectal Cancer Patients. J Clin Med. 2021;10(15)doi: 10.3390/jcm10153219.
Mihai, M. M., Ion, A., Giurcăneanu, C., Nițipir, C., Popa, A. M., Chifiriuc, M. C., Popa, M. I., Říčař, J., Popa, L. G., Sârbu, I., & Lazăr, V. (2021). The Impact of Long-Term Antibiotic Therapy of Cutaneous Adverse Reactions to EGFR Inhibitors in Colorectal Cancer Patients. Journal of clinical medicine, 10(15), . https://doi.org/10.3390/jcm10153219
Mihai, Mara Mădălina, et al. "The Impact of Long-Term Antibiotic Therapy of Cutaneous Adverse Reactions to EGFR Inhibitors in Colorectal Cancer Patients." Journal of clinical medicine vol. 10,15 (2021). doi: https://doi.org/10.3390/jcm10153219
Mihai MM, Ion A, Giurcăneanu C, Nițipir C, Popa AM, Chifiriuc MC, Popa MI, Říčař J, Popa LG, Sârbu I, Lazăr V. The Impact of Long-Term Antibiotic Therapy of Cutaneous Adverse Reactions to EGFR Inhibitors in Colorectal Cancer Patients. J Clin Med. 2021 Jul 21;10(15). doi: 10.3390/jcm10153219. PMID: 34362003; PMCID: PMC8347035.
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J Clin Med. 2021 Jul 21;10(15). doi: 10.3390/jcm10153219.

The Impact of Long-Term Antibiotic Therapy of Cutaneous Adverse Reactions to EGFR Inhibitors in Colorectal Cancer Patients.

Journal of clinical medicine

Mara Mădălina Mihai, Ana Ion, Călin Giurcăneanu, Cornelia Nițipir, Ana-Maria Popa, Mariana-Carmen Chifiriuc, Mircea Ioan Popa, Jan Říčař, Liliana Gabriela Popa, Ionela Sârbu, Veronica Lazăr

Affiliations

  1. Department of Oncologic Dermatology, 'Elias' Emergency University Hospital, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
  2. Department of Dermatology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania.
  3. Department of Microbiology, Faculty of Biology, ICUB-Research Institute of the University of Bucharest, 050657 Bucharest, Romania.
  4. Department of Oncology, 'Elias' Emergency University Hospital, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
  5. Department of Microbiology, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
  6. Department of Dermatology and Venereology, Charles University, Medical School and Teaching Hospital Pilsen, 30599 Pilsen, Czech Republic.
  7. Department of Genetics, Faculty of Biology, ICUB-Research Institute of the University of Bucharest, 050657 Bucharest, Romania.

PMID: 34362003 PMCID: PMC8347035 DOI: 10.3390/jcm10153219

Abstract

Colorectal cancer (CRC) is an important public health issue, in terms of incidence and mortality, with approximately 1.8 million new cases reported worldwide in 2018. Advancements in understanding pathophysiological key steps in CRC tumorigenesis have led to the development of new targeted therapies such as those based on epidermal growth factor receptor inhibitors (EGFR inhibitors). The cutaneous adverse reactions induced by EGFR inhibitors, particularly papulopustular rash, often require long-term antibiotic treatment with tetracycline agents (mostly minocycline and doxycycline). However, this raises several issues of concern: possible occurrence of gut dysbiosis in already vulnerable CRC patients, selection of highly antibiotic resistant and/or virulent clones, development of adverse reactions related to tetracyclines, interference of antibiotics with the response to oncologic therapy, with a negative impact on disease prognosis etc. In the context of scarce information regarding these issues and controversial opinions regarding the role of tetracyclines in patients under EGFR inhibitors, our aim was to perform a thorough literature review and discuss the main challenges raised by long-term use of tetracyclines in advanced CRC patients receiving this targeted therapy.

Keywords: EGFR inhibitors; Fusobacterium nucleatum; acneiform rash; gut microbiome dysbiosis; long-term antibiotic therapy; metastatic colorectal cancer; papulo-pustular rash; tetracyclines

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