Influence of Sorafenib, Sunitinib and Capecitabine on the Antioxidant Status of the Skin

Anticancer Res. 2018 Sep;38(9):5283-5288. doi: 10.21873/anticanres.12854.

Abstract

Background/aim: The aim of the present study was to examine the effect of orally administered sorafenib (Nexavar®), sunitinib (Sutent®) and capecitabine (Xeloda®), which cause palmoplantar erythrodysesthesia (PPE), on the antioxidant status of the skin and the formation of free radicals.

Patients and methods: A total of 42 patients were enrolled, of which 36 (85%) completed the study. Overall, 19 received capecitabine (2,000-4,000 mg per day), 10 sunitinib (25-50 mg per day) and 7 sorafenib (400-800 mg per day). Cutaneous carotenoids as markers of the antioxidant status of the skin were measured 1 day before the first oral administration (Tbase) and at day 18 of treatment (T1).

Results: The mean antioxidant concentrations increased significantly in patients treated with sunitinib from 3.99±1.01 to 4.68±1.32, p=0.047 and sorafenib from 4.83±0.74 to 5.3±0.78, p=0.007. Treatment with capecitabine did not significantly increase the mean antioxidant concentration.

Conclusion: Formation of free radicals may not be the underlying patho-mechanism of tyrosine kinase inhibitors (TKI)- and capecitabine-associated PPE.

Keywords: Cutaneous carotenoids; cutaneous toxicity by chemotherapy; free radicals; hand- and foot syndrome; nutritional intervention; reflectance spectroscopy.

MeSH terms

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Antioxidants / metabolism*
  • Capecitabine / administration & dosage
  • Capecitabine / adverse effects*
  • Carotenoids / metabolism*
  • Female
  • Hand-Foot Syndrome / metabolism*
  • Humans
  • Indoles / administration & dosage
  • Indoles / adverse effects*
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Niacinamide / administration & dosage
  • Niacinamide / adverse effects
  • Niacinamide / analogs & derivatives*
  • Phenylurea Compounds / administration & dosage
  • Phenylurea Compounds / adverse effects*
  • Pyrroles / administration & dosage
  • Pyrroles / adverse effects*
  • Skin / drug effects
  • Skin / metabolism
  • Sorafenib
  • Sunitinib

Substances

  • Antioxidants
  • Indoles
  • Phenylurea Compounds
  • Pyrroles
  • Niacinamide
  • Carotenoids
  • Capecitabine
  • Sorafenib
  • Sunitinib