Zinc supplementation decreased incidence of grade ≥2 hand-foot skin reaction induced by regorafenib: A phase II randomized clinical trial

Wen-Kuan Huang; Hung-Chih Hsu; Tsai-Sheng Yang; Chun-Wei Lu; Yi-Ru Pan; Chiao-En Wu; Wen-Hung Chung; Shuen-Iu Hung; Chun-Nan Yeh

doi:10.1016/j.ejca.2023.113286

Zinc supplementation decreased incidence of grade ≥2 hand-foot skin reaction induced by regorafenib: A phase II randomized clinical trial

Eur J Cancer. 2023 Dec:195:113286. doi: 10.1016/j.ejca.2023.113286. Epub 2023 Nov 13.

Authors

Wen-Kuan Huang¹, Hung-Chih Hsu¹, Tsai-Sheng Yang¹, Chun-Wei Lu², Yi-Ru Pan³, Chiao-En Wu¹, Wen-Hung Chung⁴, Shuen-Iu Hung⁵, Chun-Nan Yeh⁶

Affiliations

¹ Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou branch, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
² Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou branch, Taipei, Keelung, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou branch, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan.
³ Department of General Surgery, GIST team, and Liver Research Center, Chang Gung Memorial Hospital, Linkou branch, Chang Gung University, Taoyuan, Taiwan.
⁴ Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou branch, Taipei, Keelung, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou branch, Taoyuan, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou branch, Taoyuan, Taiwan.
⁵ Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou branch, Taoyuan, Taiwan; Institute of Pharmacology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁶ Department of General Surgery, GIST team, and Liver Research Center, Chang Gung Memorial Hospital, Linkou branch, Chang Gung University, Taoyuan, Taiwan. Electronic address: yehchunnan@gmail.com.

PMID: 37968194
DOI: 10.1016/j.ejca.2023.113286

Abstract

To the editor: Hand-foot skin reaction (HFSR), characterized by skin abnormalities on palmoplantar surfaces, has an overall incidence of about 35% upon vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) treatment.¹ Zinc, which plays a role in maintaining skin health, may be implicated in the pathogenesis of HFSR.² Zinc deficiency has been shown to associate with dermatological toxicities of epidermal growth factor receptor (EGFR)-TKI.^{3, 4} Regorafenib, an oral multi-kinase inhibitor targeting VEGFR 1-3, PDGFR, cKIT, BRAF, and RET1, is approved for the treatment of metastatic colorectal cancer (mCRC) but commonly causes HFSR.⁵ This phase II randomized trial aimed to investigate whether zinc supplementation can reduce the severity of HFSR induced by regorafenib within the first 8 weeks of treatment (NCT03898102).

Publication types

Randomized Controlled Trial
Clinical Trial, Phase II

MeSH terms

Dietary Supplements
Humans
Incidence
Phenylurea Compounds / adverse effects
Protein Kinase Inhibitors / adverse effects
Vascular Endothelial Growth Factor A*
Zinc*

Substances

regorafenib
Zinc
Vascular Endothelial Growth Factor A
Phenylurea Compounds
Protein Kinase Inhibitors

Associated data

ClinicalTrials.gov/NCT03898102