Dermocosmetics in Management of Cancer Related Skin Toxicities

Brigitte Dreno, Kiarash Khosrotehrani, Giselle De Barros Silva, Julie Ryan-Wolf, Delphine Kerob, Mark G. Trombetta, Etienne Atenguena Okobalemba, Pascale Dielenseger, Meng Pan, MarioE.Lacouture; Nantes Universit´e, Nantes, France; University of Queensland Diamantina Institute, Brisbane, Australia; Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil; Departments of Dermatology & Radiation Oncology, University of Rochester Medical Center, Rochester, NY; La-Roche Posay International, Paris, France; Allegheny Health Network Department of Radiologic Services, Pittsburgh, PA; Universit´e of Yaound´e I, Yaound´e, Cameroon; Gustave Roussy, France, & ´Ecole des Sciences du Cancer, Universit´e Paris Sud (XI), Villejuif, France; Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Memorial Sloan Kettering Cancer Center, New York, NY

Background:

Skin toxicities–one of the most frequent adverse events associated with cancer therapies can occur with all types of cancer therapeutic interventions. New side effects emerge as new oncology drugs are approved (eg, targeted therapies, immunotherapies), which are associated with a negative impact on quality of life, oncologic treatment dose reductions and/or treatment discontinuation. From a pathophysiologic point of view, skin toxicities during cancer treatment result mostly from alterations in skin barrier function, inflammation, altered immune responses, and phototoxicity. Minimizing alterations in skin barrier function and photoprotection facilitate prevention and management of adverse events to optimize treatment outcomes.

Methods:

In partnership with the Association Francophone des Soins Oncologiques de Support (AFSOS) and Multinational Association of Supportive Care in Cancer (MASCC), a group of international experts (dermatologists, oncologist, radiation oncologist, oncology nurse) involved in management of cancer patients performed a literature review and a consensus meeting to discuss the role of dermocosmetics to prevent or manage skin adverse events induced by oncology treatments. Dermocosmetics, or cosmeceuticals, include a range of products that can have both therapeutic and cosmetic value. These products help support and maintain the epidermal skin barrier and cutaneous microbiome. Some have been formulated for skin that is fragile, pathological, and sensitive.

Results:

General recommendations: 1) skin care should be implemented at initiation of therapy for drugs associated with skin toxicities, since prevention is a crucial aspect of management. 2) Skin hydration relieves symptoms and reduces exacerbations of xerosis. 3) Cleansers should have a pH close to 5, while basic and neutral pH cleansers should be avoided. 4) Urea, particularly in the case of some oncology treatments leading to hand foot syndrome, is important due to its exfoliating and hydrating actions. Urea should be avoided with irritated skin. The group also developed recommendations for the management of specific skin toxicities.

Conclusions:

Emerging evidence is providing support for the beneficial impact of dermocosmetics in management of treatment-related skin toxicities.

Research Sponsor:

La-Roche Posay International.