Diagnosis and treatment of cutaneous adverse effects of targeted therapy, antibody-drug conjugates, and immunotherapy in cancer patients: a national consensus statement by the Spanish Society of Medical Oncology and the Spanish Academy of Dermatology and Venereology

Abstract

Cancer remains a leading cause of mortality in developed countries, with advancements in targeted therapies, antibody-drug conjugates (ADCs), and immunotherapy significantly improving patient survival. However, these treatments often result in cutaneous adverse effects (AEs), impacting the skin, mucosa, hair, and nails. This expert consensus statement provides a comprehensive overview of the mechanisms behind these skin toxicities, their clinical manifestations, and the importance of rapid diagnosis and treatment. The spectrum of skin toxicities ranges from mild reactions such as xerosis and pruritus to severe, potentially life-threatening conditions such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). This statement underlines the need for healthcare professionals to work in multidisciplinary teams, use standardized classification systems such as the Common Terminology Criteria for AEs (CTCAE) v5.0, educate patients on preventive measures, and establish clinical management guidelines to mitigate these AEs. By understanding the pathophysiological mechanisms and implementing effective management strategies such as photoprotection, gentle hygiene, emollients, prophylactic antibiotics, or specific hair and nail care, the quality of life for cancer patients can be significantly improved, ensuring continuity of oncologic treatment and improving overall survival.