Efficacy, tolerability and impact on quality of life of clindamycin phosphate and benzoyl peroxide for the treatment of cetuximab-associated acneiform eruption in patients with metastatic colorectal cancer

Background: Epidermal growth factor receptor inhibitors are recent antineoplastic treatments used for the treatment of some non-cutaneous tumours, which aberrantly express EGFR. Because of their specificity, these drugs have low systemic toxicity, but frequent undesired cutaneous effects, the most common of which is an acneiform eruption, occurring after 1-3 weeks of treatment. Management of this rash is not well standardized. Objective: We evaluated efficacy, tolerability and impact on quality of life of a clindamycin phosphate 1.2%-benzoyl peroxide 5% gel in 12 male adults who developed acneiform eruption during treatment with cetuximab for metastatic colorectal cancer. Methods: Patients applied the clindamycin phosphate-benzoyl peroxide gel once daily, at evening, for 8 weeks. The Skin-Score was used to evaluate reduction of erythema, papules, pustules and pruritus, the Dermatology Life Quality Index questionnaire to evaluate the improvements of health-related quality of life. Results: Significant clinical improvements occurred after 2 weeks of treatment and were even more evident after 8 weeks (mean Skin-Score 20.54 +/- 7.83, p=1.37x10(-6) vs. second week visit, p=1.26x10(-7) vs. before treatment). Accordingly, DLQI values decreased from 13.64 +/- 2.01 before treatment to 6.45 +/- 1.37 after 8 weeks (p=1.12x10(-5)). Conclusion: A clindamycin phosphate-benzoyl peroxide gel may be an effective and safe option in the treatment of cetuximab-associated acneiform eruptions.