We describe the case of a young man with refractory renal cell carcinoma who achieved an objective response in a metastatic lesion after biotherapy with the multikinase inhibitor sorafenib and also developed a severe skin reaction. The patient had been previously treated with various combinations of immunochemotherapy without any clinical benefit. We performed a brief review of the literature where similar cases were documented with the use of various anti-EGFR agents. The hypothesis of the correlation of skin toxicity with disease response is not new, but in the absence of any strong evidence remains controversial.
RatainM., EisenT., StadlerW., FlahertyK., KayeS., RosnerG., GoreM., DesaiA., PatnaikA., XiongH., RowinskyE., AbbruzzeseJ., SimantovR., SchwartzB., O'DwyerP.: Phase II placebo-controlled randomized discontinuation trial of sorafenib in patients with metastatic renal cell carcinoma.J Clin Oncol, 24: 2505–2512, 2006.
2.
StrumbergD.: Preclinical and clinical development of the oral multikinase inhibitor sorafenib in cancer treatment.Drugs Today (Barc), 41: 773–784, 2005.
3.
AhmadT., EisenT.: Kinase inhibition with BAY 43-9006 in renal cell carcinoma.Clin Cancer Res,10(suppl): S6388–S6392, 2004.
4.
VeroneseM.L., MosenkisA., FlahertyK.T., GallagherM., StevensonJ., TownsendR., O'DwyerP.: Mechanisms of hypertension associated with BAY 43-9006.J Clin Oncol, 24: 1363–1369, 2006.
5.
SchöffskiP., DumezH., ClementP., HoebenA.: Emerging role of tyrosine-kinase inhibitors in the treatment of advanced renal cell cancer: a review.Ann Oncol, 17: 1185–1196, 2006.
6.
StrumbergD., AwadaA., HirteH., ClarkJ., SeeberS., PiccartP., HofstraH., VoliotisD., ChristensenO., BruecknerA., SchwartzB.: Pooled safety analysis of BAY43-9006 (sorafenib) monotherapy in patients with advanced solid tumours: Is rash associated with treatment outcome?Eur J Cancer,42: 548–556, 2006.
7.
RobertC., SoriaJ.C., SpatzA., Le CesneA.: Cutaneous side-effects of kinase inhibitors and blocking antibodies.Lancet Oncol, 6: 491–500, 2005.
8.
Perez-SolerR., SaltzL.: Cutaneous adverse effects with HER1/EGFR-targeted agents: is there a silver lining?J Clin Oncol,23: 5235–5246, 2005
9.
EscudierB., SzczylikC., EisteinT., StadlerW., SchwartzB., ShanM., BukowskiR.M.: Randomized phase III trial of the Raf-kinase and VEGF inhibitor sorafenib (43-9006) in patients with advanced renal cell carcinoma. ASCO Annual Meeting Proceedings, abstract 4510, 2005.
10.
LynchT.J., BellD.W., SordellaR., GurubhagavatulaS., OkimotoR.A., BranniganB.W., HarrisP.L., HaserlatS.M., SupkoJ.G., HaluskaF., LouisD., ChristianiD., SettlemanJ., HaberD.: Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib.N Engl J Med, 350: 2129–2139, 2004.
11.
SusmanE.: Rash correlates with tumour response after cetux- imab.Lancet Oncol, 5: 647, 2004.
