Cutaneous Adverse Effects of EGFR Therapy in Breast Cancer Treatment

Abstract

Breast cancer is among the most common cancers in U.S. women. Epidermal growth factor receptor inhibitors (EGFRIs) target pathways driving tumor growth but frequently cause dermatologic toxicities that impact quality of life and treatment adherence. This review summarizes the clinical features, mechanisms, and management of EGFRI-related skin adverse effects. A comprehensive PubMed search yielded 134 studies that discussed EGFRI treatment in breast cancer patients. Studies were included if they published over the past 10 years (between 2014 and 2024), reported data on females treated with EGFRI for active breast cancer, and included cutaneous side effects. Ninety articles met this inclusion criteria. Findings indicate that the severity of skin toxicity is influenced by patient-specific factors such as age, nutrition, lifestyle, genetics and ethnicity, as well as treatment-related factors including drug dosage and combination therapies. Common toxicities include papulopustular rashes, xerosis, pruritus, alopecia, and severe reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis. The specific type of EGFRI (monoclonal antibodies or tyrosine kinase inhibitors) also affects the nature of dermatological reactions. Management strategies include prophylactic skin care, symptomatic treatments, and emerging therapies such as laser therapy. Chemotherapy-induced skin toxicities from EGFRI in breast cancer treatment significantly impact patient quality of life and treatment adherence. This study underscores the need for proactive management as well as conversations with patients regarding the cutaneous adverse effects prior to starting EGFR treatment to enhance patient awareness.

Keywords: breast cancer; chemotherapy‐induced skin toxicity; cutaneous adverse effects; dermatologic management; epidermal growth factor receptor inhibitors; quality of life.