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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1812854
Original Article

Hospital-Based Observational Study of Mucocutaneous Adverse Reactions of Tyrosine Kinase Inhibitors

Authors

  • Sona C. Gowda

    1   Department of Dermatology, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, Karnataka, India

  • Tonita Mariola Noronha 

    1   Department of Dermatology, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, Karnataka, India

  • Vijith Shetty

    2   Department of Medical Oncology, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, Karnataka, India

Funding None.
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Abstract

Introduction

Tyrosine kinase inhibitors (TKIs), although considered less toxic than conventional chemotherapy, are not short of adverse drug reactions (ADRs). Cutaneous toxicities are among the most frequently reported ADRs; when severe, they can cause substantial morbidity, often requiring dose reduction or drug cessation.

Objectives

1. To estimate the frequency and pattern of mucocutaneous adverse reactions of TKI. 2. To grade the adverse reactions based on the severity scale of CTCAE v 5.0.

Materials and Methods

This was a hospital-based observational study of 105 patients on TKI chemotherapy, attending the outpatient departments of dermatology and medical oncology, at Justice K.S. Hegde Charitable Hospital, Mangalore, from October 1, 2022, to April 30, 2024. Mucocutaneous adverse reactions after the initiation of TKI were recorded and graded according to the severity scale of CTCAE v 5.0. and causality was assessed using WHO-UMC criteria.

Results

Among 105 patients, a majority of 34 (32.4%) patients belonged to the age group of 51 to 60 years, with a male predominance of 2:1. The most frequent cancer was lung in 38 (36.2%) patients, followed by CML in 21 (20.0%) patients. The most common class of TKI agent used was EGFR inhibitors in 51 (48.6%) patients, with gefitinib being the most common TKI agent in 46 (43.8%) patients. The most frequently reported ADRs were xerosis in 45 (42.9%) patients, followed by eczematous changes in 37 (35.2%) patients. The papulopustular rash was most commonly seen with EGFR inhibitors in 25 (49.0%) patients, eczematous changes with BCR–ABL inhibitors in 14 (50.0%), and hand–foot skin reaction with multikinase inhibitors in 12 (54.4%) patients. A statistically significant association was noted between papulopustular rash and paronychia among patients on EGFR inhibitors. Additionally, a statistically significant association was noted between hand–foot skin reaction and subsequent dose reduction.

Conclusion

An awareness regarding the various ADRs of TKIs and interdisciplinary cooperation between oncologists and dermatologists will help in precise diagnosis and early identification of various cutaneous toxicities.

Keywords

adverse drug reactions - tyrosine kinase inhibitors - EGFR inhibitors - targeted chemotherapy

Patients' Consent

Photographs of the cutaneous lesions of patients who consented to it were taken, and the patients' identities were kept confidential.


Supplementary Material



Publication History

Article published online:
30 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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