Evolving Strategies for the Management of Hand–Foot Skin Reaction Associated with the Multitargeted Kinase Inhibitors Sorafenib and Sunitinib MARIO E. LACOUTURE, a SHENHONG WU, b CAROLINE ROBERT, c MICHAEL B. ATKINS, d HEIDI H. KONG, e JOAN GUITART, a CLAUS GARBE, f AXEL HAUSCHILD, g IGOR PUZANOV, h DORU T. ALEXANDRESCU, i ROGER T. ANDERSON, j LAURA WOOD, k JANICE P. DUTCHER l a Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; b Division of Medical Oncology, Department of Medicine, Stony Brook University Cancer Center, Stony Brook, New York, USA; c Dermatology Unit, Gustave-Roussy Institute, Villejuif, France; d Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; e Dermatology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA; f Department of Dermatology, Eberhard Karls University, Tb ¨ ingen, Germany; g Department of Dermatology, University of Kiel, Kiel, Germany; h Division of Hematology/Oncology, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA; i Georgetown Dermatology, Washington, District of Columbia, USA; j Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA; k Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio, USA; l Our Lady of Mercy Medical Center, Comprehensive Cancer Center, New York Medical College, Bronx, New York, USA Key Words. Sorafenib • Sunitinib • Hand–foot skin reaction • Forum consensus • Skin Disclosure: Employment/leadership position: None; Intellectual property rights/inventor/patent holder: None; Consultant/advisory role: Michael B. Atkins, Bayer/Onyx; Doru T. Alexandrescu, Bayer; Roger T. Anderson, Bayer; Claus Garbe, Bayer; Axel Hauschild, Bayer, Onyx; Janice P. Dutcher, Bayer/Onyx, Pfizer, Wyeth, Genentech; Mario E. Lacouture, Onyx, Bayer; Igor Puzanov, Spirogen; Caroline Robert, Bayer; Shenhong Wu, Onyx; Honoraria: Axel Hauschild, Bayer, Onyx; Laura Wood, Bayer/Onyx, Pfizer; Janice P. Dutcher, Bayer/Onyx, Pfizer, Wyeth, Novartis; Igor Puzanov, Pfizer, Novartis, Bayer; Shenhong Wu, Pfizer; Research funding/contracted research: Michael B. Atkins, Bayer/Onyx; Axel Hauschild, Bayer (Germany), Onyx (USA); Janice P. Dutcher, Bayer/Onyx, Pfizer, Wyeth, Genentech, Novartis; Mario E. Lacouture, Onyx; Ownership interest: None; Expert testimony: None; Other: None. The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors, planners, independent peer reviewers, or staff managers. ABSTRACT The multitargeted kinase inhibitors (MKIs) sorafenib and sunitinib have shown benefit in patients with renal cell carcinoma, hepatocellular carcinoma (sorafenib), and gastrointestinal stromal tumor (sunitinib). Their ef- ficacy in other malignancies is currently being investi- gated because of their broad range of activity. The effectiveness of these drugs is somewhat diminished by the development of a variety of toxicities, most notably hand–foot skin reaction (HFSR). Although HFSR does not appear to directly affect survival, it can impact qual- Correspondence: Mario E. Lacouture, M.D., Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 1600, Chicago, Illinois 60611, USA. Telephone: 312-695-8106; Fax: 312-695-0537; e-mail: m-lacouture@northwestern.edu Received June 11, 2008; accepted for publication July 30, 2008. ©AlphaMed Press 1083-7159/2008/ $30.00/0 doi: 10.1634/theoncologist.2008-0131 T he O ncologist ® Symptom Management and Supportive Care The Oncologist 2008;13:000 – 000 www.TheOncologist.com Published Ahead of Print on September 8, 2008 as 10.1634/theoncologist.2008-0131. by guest on December 4, 2015 http://theoncologist.alphamedpress.org/ Downloaded from