Abstract / Summary
Background: The use of targeted therapies in oncology has increased significantly, but associated cutaneous adverse events often impair quality of life and adherence. Despite numerous available interventions, there is no unified protocol, and many patients discontinue therapy due to adverse events. This systematic review and meta-analysis aimed to evaluate preventive and reactive interventions for cutaneous adverse events in adult cancer patients receiving kinase inhibitors. Methods: A search was performed in MEDLINE (via PubMed), EMBASE, and CENTRAL (The Cochrane Central Register of Controlled Trials), using predefined search terms. Outcomes were incidence, severity of cutaneous adverse events (grades 1–4 and 3–4), quality of life and adherence to oncologic therapy. Results: After screening 35,072 records, 9 studies (1853 patients, per protocol) met the inclusion criteria for the meta-analysis, while 52 were included in the systematic review. Preventive topical agents significantly reduced the incidence of grade 1–4 cutaneous adverse events (OR, 0.55; 95% CI, 0.38–0.80; p = 0.012; I2 = 16%), whereas systemic interventions showed no significant benefit in this category. Conversely, for grade 3–4 events, systemic interventions were associated with a significantly reduced incidence (OR, 0.24; 95% CI, 0.14–0.41; p = 0.002, I2 = 0%), while topical agents had no significant effect. For reactive interventions, no consistent evidence of effectiveness was found, with high heterogeneity and a limited number of studies. Conclusions: In patients receiving kinase inhibitors, systemic antibiotics were associated with a reduction in grade 3–4 cutaneous adverse events, while pooled topical interventions significantly reduced grade 1–4 events. However, the effectiveness of individual topical agents, including urea, remains uncertain.