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Targeted cancer therapies may cause pigmentary changes

More than 15% of patients treated with targeted cancer therapies experienced all-grade pigmentary changes in the skin and hair, according to results of a recent systematic review and meta-analysis of published clinical trials.

The analysis included 8,052 patients from 36 clinical trials.

Results indicated an overall rate of all-grade pigmentary changes to the skin associated with targeted cancer therapies of 17.7% (95% CI, 11.9-25.4). These therapies yielded changes to the hair in 21.5% (95% CI, 14.9-30.1) of patients.

The researchers also calculated relative risk for all-grade pigmentary changes and found that targeted cancer therapies caused changes in the skin (RR = 93.7; 95% CI, 5.86-1497.164) and hair (RR = 20.1; 95% CI, 8.35-48.248).

Findings for 75 patients in 53 case reports or case series suggested that epidermal growth factor receptors and breakpoint cluster region-abelson inhibitors were the agents most likely to cause pigmentary changes.

Other findings indicated that sunitinib (Sutent, Pfizer) was associated with a 75% rate of all-grade pigmentary changes in a single cohort of patients with relapsed or refractory small cell lung cancer. This was the highest rate of skin pigmentary changes. Pazopanib (LartruvoVotrient, LillyNovartis) yielded the lowest incidence of skin pigmentary changes at 0.7%, according to findings from a single phase 3 study of patients with metastatic renal cell carcinoma.

Pazopanib was associated with a 43.8% rate of hair color changes in an open-label study in patients with advanced renal cell carcinoma. Sunitinib yielded the lowest incidence of hair color changes (3.7%) in a phase 3 study of patients with metastatic renal cell carcinoma.

“There is a significant risk of development of pigmentary changes during treatment with targeted anticancer therapies,” the researchers concluded. “Appropriate counseling and management are critical to minimize psychosocial impairment and deterioration in quality of life.” – by Rob Volansky

Disclosures: Dai reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.