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ONS Guidelines Article
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Targeted Therapy– and Chemotherapy-Associated Skin Toxicities: Systematic Review and Meta-Analysis

Jingyi Francess Ding
Magdoleen H. Farah
Tarek Nayfeh
Konstantinos Malandris
Apostolos Manolopoulos
Pamela K. Ginex
Bashar Hasan
Hayley Dunnack
Rami Abd-Rabu
Moutie Rami Rajjoub
Larry James Prokop
Rebecca L. Morgan
M. Hassan Murad
ONF 2020, 47(5), E149-E160 DOI: 10.1188/20.ONF.E149-E160

Problem Identification: Preventing and managing skin toxicities can minimize treatment disruptions and improve well-being. This systematic review aimed to evaluate the effectiveness of interventions for the prevention and management of cancer treatment–related skin toxicities.

Literature Search: The authors systematically searched for comparative studies published before April 1, 2019. Study selection and appraisal were conducted by pairs of independent reviewers.

Data Evaluation: The random-effects model was used to conduct meta-analysis when appropriate.

Synthesis: 39 studies (6,006 patients) were included; 16 of those provided data for meta-analysis. Prophylactic minocycline reduced the development of all-grade and grade 1 acneform rash in patients who received erlotinib. Prophylaxis with pyridoxine 400 mg in capecitabine-treated patients lowered the risk of grade 2 or 3 hand-foot syndrome. Several treatments for hand-foot skin reaction suggested benefit in heterogeneous studies. Scalp cooling significantly reduced the risk for severe hair loss or total alopecia associated with chemotherapy.

Implications for Research: Certainty in the available evidence was limited for several interventions, suggesting the need for future research.

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