BACKGROUND: Epidermal growth factor receptor (EGFR) and cellular-mesenchymal to epithelial transition factor (c-Met) are widely expressed on cancer cells. There is a synergistic effect of EGFR and HGF/c-Met pathways on proliferation, downstream activation of signal transduction and an additive effect. Studies show that combination of both signaling pathways could potentially be targeted in a synergistic fashion. Amivantamab, a bispecific monoclonal antibody targeting EGFR and c-Met, yielded robust and durable responses in a variety of clinicals trials. However, few researches have reported its efficacy in Chinese non-small cell lung cancer (NSCLC) patients. This study was conducted to evaluate the effectiveness and tolerance of Amivantamab in NSCLC patients with EGFR/MET gene abnormalities at Peking University Cancer Hospital. METHODS: The study enrolled NSCLC patients who received Amivantamab in our hospital between August 2020 and December 2021, and analyzed the response, survival, and treatment-related adverse events. RESULTS: Fifteen patients were enrolled in this research, and six of them received Amivantamab treatment and the other nine patients received Amivantamab plus Lazertinib treatment. The rates of partial response (PR), stable disease (SD), and progressive disease (PD) were 46.7% (7/15), 46.7% (7/15) and 6.7% (1/15), respectively. The overall response rate (ORR) and disease control rate (DCR) were 28.6% (2/7) and 100.0% (7/7) in seven patients with EGFR exon 20 insertion, respectively. The ORR and DCR were 40.0% (2/5) and 100.0% (5/5) in five post-osimertinib EGFR-mutant patients, respectively. After a median follow-up of 8.7 months, the median progression-free survival and overall survival were not reached. The most common treatment-related adverse events were rash (86.7%), paronychia (80.0%), and infusion-related reactions (60.0%), and most of them were graded as 1 to 2. Grade 3 to 4 adverse events included rash (33.3%), alanine aminotransferase elevation (13.3%), gamma-glutamyl transpeptidase elevation (13.3%), peripheral edema (6.7%), thromboembolism (6.7%), interstitial lung disease (6.7%), and thrombocytopenia (6.7%). CONCLUSIONS Amivantamab was effective in Chinese NSCLC patients with EGFR exon 20 insertion and post-Osimertinib EGFR-mutant patients, similar to the results of clinical trials conducted in western countries. Amivantamab was well tolerated and emphases should be put on adverse events such as rash, paronychia, and infusion-related reactions.
Antibodies, Bispecific ; Carcinoma, Non-Small-Cell Lung/genetics* ; ErbB Receptors/genetics* ; Exanthema/drug therapy* ; Humans ; Lung Neoplasms/genetics* ; Mutation ; Paronychia/drug therapy* ; Protein Kinase Inhibitors/therapeutic use*

Docetaxel is a new taxoid antineoplastic drug widely used for advanced breast cancer, lung cancer, and head and neck cancer. Skin and nail change is one of the most frequent nonhematologic adverse reactions. Nail changes include dark pigmentation, subungal hemorrhage, acute paronychia, onycholysis and Beau's line. A 43-year-old woman with metastatic stomach cancer developed painful subungal abscess and secondary onycholysis of all fingernails after three courses of docetaxel chemotherapy(cumulative dose: 360mg). Puncturing under the nail plate expressed a purulent serous fluid. Microbiological cultures revealed heavy growth of Staphylococcus aureus. The docetaxel therapy was discontinused and 3rd generation cephalosporin was started. After 3-weeks antibiotic therapy, subungal abscess was improved. To our knowlege, this is the second case report of subungal abscess related to docetaxel chemotherapy.
Abscess* ; Adult ; Breast Neoplasms ; Drug Therapy ; Female ; Head and Neck Neoplasms ; Hemorrhage ; Humans ; Lung Neoplasms ; Nails ; Onycholysis* ; Paronychia ; Pigmentation ; Skin ; Staphylococcus aureus ; Stomach Neoplasms

BACKGROUND: Epidermal growth factor receptor (EGFR) inhibitors are associated with cutaneous adverse events, including papulopustular eruption, xerosis, paronychia, hair abnormality and mucositis. In particular, acneiform eruptions might serve as the visible markers of anti-tumor activity and the therapeutic efficacy of EGFR inhibitors. OBJECTIVE: Our aims are to investigate the common cutaneous adverse events induced by cetuximab, which is one of the EGFR inhibitors approved by the US Food and Drug Administration, and to analyze whether the presence and severity of papulopustular eruptions have a correlation with the tumor response. METHODS: We retrospectively reviewed the medical records and clinical photographs of 114 Korean patients who had been treated with cetuximab at Asan Medical Center from September 2004 to March 2007. Results: Papulopustular eruptions occurred in 100 patients (87.7%) and this usually happened 10 days after starting chemotherapy. There was a tendency that the better the tumor responded to the chemotherapeutic agents including cetuximab, the more severe were the papulopustular eruptions. The papulopustular eruptions prominently improved after the treatment with topical agents such as benzoyl peroxide, metronidazole, clindamycin and retinoid, and with systemic agents such as minocycline and tetracycline, and there was no adverse event induced by this treatment for papulopustular eruptions. Xerosis appeared in 67 patients (58.8%), and there was a tendency that the more severe papulopustular eruptions were, the more frequently xerosis occurred. Paronychia occurred in 8 patients (7.0%). CONCLUSION: Although the cutaneous adverse events are burdensome to the patients, they might serve as visible markers of the anti-tumor activity and therapeutic efficacy of cetuximab and they can be easily and safely controlled with many topical and systemic agents. Therefore, it is important for dermatologists to properly treat these cutaneous adverse events and to reassure the patient to continue with the cetuximab treatment.
Acneiform Eruptions ; Antibodies, Monoclonal, Humanized ; Benzoyl Peroxide ; Clindamycin ; Drug Therapy, Combination ; Hair ; Humans ; Medical Records ; Metronidazole ; Minocycline ; Mucositis ; Paronychia ; Receptor, Epidermal Growth Factor ; Retrospective Studies ; Tetracycline ; United States Food and Drug Administration ; Cetuximab