Alopecia in patients treated with molecularly targeted anticancer therapies
A partir d'une revue systématique de la littérature, cette étude fait le point sur l'association entre diverses thérapies ciblées et le risque d'alopécie chez des patients atteints de cancer
BACKGROUND The introduction of molecularly targeted anticancer therapies presents new challenges, among which dermatologic adverse events are noteworthy. Alopecia in particular is frequently reported, but the true incidence is not known. PATIENTS AND METHODS We sought to ascertain the incidence and risk of developing alopecia during treatment with approved inhibitors of oncogenic pathways and molecules (ALK, Bcr-abl, BRAF, BTK, CTLA-4, EGFR, HER2, JAK, MEK, mTOR, SMO, VEGF, VEGFR, PDGFR; proteasomes; CD20, CD30, CD52). Electronic database (Pubmed, Web of Science) and ASCO meeting abstract searches were conducted to identify clinical trials reporting alopecia. Meta-analysis was conducted utilizing fixed- or random-effects models. RESULTS The calculated overall incidence of all-grade alopecia was 14.7% (95% confidence interval [CI]: 12.6-17.2%)—lowest with bortezomib, 2.2% (95% CI: 0.4-10.9%), and highest with vismodegib, 56.9% (95% CI: 50.5-63.1%). There was an increased risk of all-grade alopecia (relative risk [RR], 7.9 [95% CI: 6.2-10.09, P=<0.01]) compared with placebo, but when compared with chemotherapy, the risk was lower (RR, 0.32 [95% CI: 0.2-0.55, P=<0.01]). CONCLUSIONS Targeted therapies are associated with an increased risk of alopecia.