Markers in the epidermal growth factor receptor pathway and skin toxicity during erlotinib treatment

A. R. Tan, S. M. Steinberg, A. L. Parr, D. Nguyen, S. X. Yang

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Background: Skin toxicity is a common adverse effect of erlotinib and other anti-epidermal growth factor receptor (EGFR) agents. The aim of the study was to explore the relationship between markers in the EGFR pathway and skin rash. Patients and methods: Eighteen patients with metastatic breast cancer were treated with daily oral erlotinib at 150 mg. Skin biopsies were obtained at baseline and after 1 month of treatment in 15 patients. EGFR, phosphorylated EGFR (pEGFR), phosphorylated mitogen-activated protein kinase (pMAPK), and phosphorylated Akt (pAkt) or Ki67 were examined quantitatively by immunohistochemistry. Results: 11 of 18 (61%, 95% confidence interval 35.7% to 82.7%) patients developed skin rash. pAkt at baseline was significantly higher in patients with no rash than those with a grade 1 or 2 rash (18.8 ± 8.3 versus 2.4 ± 1.2 versus 3.3 ± 3.3; P = 0.0017 for trend). There was a trend towards a significant increase of pMAPK in skin posttreatment with increasing grade of rash (no rash versus grade 1 versus grade 2 rash: 4.5 ± 2.3 versus 8.4 ± 4.2 versus 19.4 ± 4.6; P = 0.036). Other markers were not associated with rash. Conclusions: pAkt was significantly associated with not developing a rash and may have a predictive utility for skin toxicity in patients treated with erlotinib and possibly with other anti-EGFR agents.

Original languageEnglish (US)
Pages (from-to)185-190
Number of pages6
JournalAnnals of Oncology
Issue number1
StatePublished - Jan 2008
Externally publishedYes


  • EGFR pathway markers
  • Erlotinib
  • Skin toxicity

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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