LEARNING OUTCOMES
The aim of the course is for students to understand a) the classification of the anticancer drugs that cause skin adverse effects and their mechanism of action with emphasis to the targeted therapy (kinase inhibitors, monoclonal antibodies b) skin adverse effects of radiotherapy c) the drugs and dermato-cosmetics usually used for the treatment of skin adverse effects and d) the basic principles of dermato-oncology
The goal of the course is for the students to acquire the necessary knowledge for the efficient support of the pharmaceutical and dermato-cosmetic treatment of the skin adverse effects of the chemotherapy and radiotherapy.
Learning results
After the end of the course the students will be able to know:
- The mechanism of action of the classic anticancer agents and targeted therapy, as well
- The adverse skin effects of the classic anticancer agents and the targeted therapy, as well
- The skin adverse effects of radiotherapy
- The pharmaceutical and dermato-cosmetic treatments used for the precaution or the decrease of intensity and the frequency of skin adverse effects due to chemotherapy/radiotherapy
- The systemic and topical medications indicated for the skin adverse effects in oncology patients
And will be able to:
Be members of groups of supportive dermato-oncology and to support efficiently in the clinical practice the treatment of skin adverse effects of chemotherapy, targeted therapy and radiotherapy.
SYLLABUS
1. Supportive Dermato-oncology.
2. Classification of the anticancer drugs and their mechanism of action.
3. Classic Chemotherapy: Mitosis inhibitors (taxanes, Vinca alkaloids) and skin adverse effects: alopecia, itching, dryness, erythema, hand-foot syndrome, dark lines on the nails, abnormal development of the nails, onycholysis. Pharmaceutical and dermato-cosmetic treatment.
4. Classic Chemotherapy-Mechanism of action: Genotoxic drugs. Platinum derivatives. Intercalation compounds, inhibitors of topoisomerase I (topotecan). Skin adverse effects: erythema, itching, localized hyperpigmentation, hand-foot syndrome, alopecia. Classic chemotherapy: Antimetabolites and moderate skin adverse effects.
5. Medical camouflage (PMU) for the restoration of the eye-brows alopecia in oncology patients as a part of psychological support methods. Chemical classification of the colors used. Safety of these colors and the PMU techniques for the oncology patients.
6. Targeted therapy. Tyrosine kinase inhibitors. Inhibitors of the epidermal growth factor receptor (EGFRIs gefitinib, erlotinib, EGFR/Erb2 – lapatinib) and monoclonal antibodies (mAbs).
7. Tyrosine kinase and pustular rash and maculopapular rash. Distortion of the skin barrier. Classification of the rash according to National Cancer Institute (N.C.I) 4.03 criteria, Topical use of steroids. Calcineurin. Pharmaceutical algorithm according to the N.C.I criteria. Dermato-cosmetic preparations for the limitation of the rash.
8. EGFRIs and skin dryness-xerosis, Skin hydration preparations-ingredients-types of emulsions indicated. Bandages with emollients. EGFRIs and itching. Dermato-cosmetic methods for the treatment of itching. Pharmaceutical treatment: pregabalin and gabapentin. EGFRIs and paronychia. EGFRIs and hair growth-trichomegaly.
9. Multiple kinase inhibitors (MKIs). Vascular endothelial growth factor receptor inhibitors (VEGFRIs) and platelet derived growth factor inhibitors (PFGFRIs). VEGFRIs and rash. Classification according to 4.03 criteria (N.C.I). Xerosis. Erythrodysesthesia plaque. Dermato-cosmetics for the first stages of rush.
10. RAS-RAF-MEK-ERK inhibitors. Mechanism of action. Kinase inhibitors. BRAF inhibitors and skin adverse effects. Rash, hyperkeratosis, keratoacanthomas. Photoprotection during therapy with BRAF inhibitors.
11. MEK inhibitors. Mechanism of action and skin adverse effects. Maculopapular rash, xerosis, paronychia, pruritus.
12. Radiotherapy and targeted therapy with monoclonal antibodies. Correlation between therapy with mAbs i.e cetuximab and intensity of the rash (therapeutic index)
13. Radiotherapy and skin adverse effects, hyaluronates and antioxidants in the treatment of the skin adverse effects of radiotherapy.