ResearchArticle Prophylactic Dermatologic Treatment of Afatinib-Induced Skin Toxicities in Patients with Metastatic Lung Cancer: A Pilot Study Maria Pia Fuggetta , 1 Maria Rita Migliorino, 2 Serena Ricciardi, 2 Giorgia Osman, 2 Daniela Iacono, 2 Alvaro Leone, 3 Alessandra Lombardi, 2 Giampietro Ravagnan, 1 Stefania Greco, 2 Daniele Remotti, 3 and Maria Concetta Pucci Romano 4 1 Institute of Translational Pharmacology, CNR, Rome, Italy 2 UOSD of Oncologic Pneumology, San Camillo Forlanini Hospital, Rome, Italy 3 UOC of Anatomopathology, San Camillo Forlanini Hospital, Rome, Italy 4 UOSD of Dermatology, San Camillo Forlanini Hospital, Rome, Italy Correspondence should be addressed to Maria Pia Fuggetta; mariapia.fuggetta@ift.cnr.it Received 25 June 2018; Revised 2 October 2018; Accepted 16 December 2018; Published 31 January 2019 Academic Editor: Mauro Alaibac Copyright©2019MariaPiaFuggettaetal.isisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Severe skin rash is listed among important side effects of EGFR tyrosine kinase inhibitors. Polydatin (PD), a glycosylated polyphenol, is endowed with anti-inflammatory activity in human epidermal keratinocytes. Objective. is study evaluated the effect of topical application of a moisturizer containing PD to prevent skin rash in patients with mutated non-small cell lung cancer (NSCLC) treated with afatinib. Materials and Methods. Eligible NSCLC patients with metastatic disease were treated with first-line afatinib 40 mg/die. One day before starting systemic therapy, all patients received topical administration of a 1.5% PD-based cream b.i.d. every day until the end of afatinib treatment. Results. Out of 34 treated patients, the incidence of skin rash (all grades) was 41.2% and grade 2 rash was 20.6%, and grade 3 rash was not observed in any of the patients. None of the patients discontinued therapy for toxicity. e mean duration of treatment was 6.4 months, calculated from the time treatment was started to the date treatment was stopped. Conclusion. e results showed that a PD-based cream can reduce the incidence of grade ≥2 skin toxicities in patients treated with afatinib. Clinical study registration number: Prot. No. 130/CE Lazio 1 Italy. 1.Introduction In recent years a substantial progress has been achieved in the treatment of non-small cell lung cancer (NSCLC) through molecular analysis capable of driving the devel- opment of more efficient and selective targeted therapy [1]. e epidermal growth factor receptor (EGFR or ErbB1 or HER1), a tyrosine kinase receptor, can activate a wide range of signalling pathways leading to cell growth, pro- liferation, and survival [2]. Overexpression of EGFR is strongly associated with the development and progression of several malignant tumours, including advanced NSCLC [3]. EGFR is overexpressed and frequently mutated in up to 40–80% of NSCLC and has been considered a good can- didate as therapeutic target. e two most common mu- tations are exon 19 deletions (60%) and L858R missense substitutions at position 858 (35%), where leucine is replaced by arginine, leading to constitutive activation of the receptor [4, 5]. Mutant EGFR can be inhibited either by low- molecular-weight tyrosine kinase inhibitors (TKIs such as gefitinib, afatinib, and erlotinib) or monoclonal antibodies (e.g. cetuximab) [4–7]. Afatinib is a potent second- generation irreversible ErbB family blocker that inhibits tyrosine kinase activity of EGFR and all relevant ErbB family dimmers [8]. In recent clinical trials, afatinib alone was found to be superior to platinum-based doublet chemo- therapy in terms of either progression-free survival or overall survival of non-pretreated NSCLC patients with activating EGFR mutations [9–12]. In general, the cutaneous toxicities associated with these targeted agents can potentially affect patient quality of life and treatment compliance and predispose the skin to Hindawi Scientifica Volume 2019, Article ID 9136249, 6 pages https://doi.org/10.1155/2019/9136249