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Table 2 Recommended prevention/management strategies for skin toxicities consistent with hand-foot skin reaction/hand-foot syndrome

From: A phase 3 tRial comparing capecitabinE in combination with SorafenIb or pLacebo for treatment of locally advanced or metastatIc HER2-Negative breast CancEr (the RESILIENCE study): study protocol for a randomized controlled trial

Toxicity grade

Practical prevention/management strategies for HFSR/HFS

Grade 0 (preventive strategies)

● Maintain frequent contact with trial physician to ensure early diagnosis of HFSR

● Practical prevention strategies

 ○ Pedicure by a podiatrist for subjects with pre-existing hyperkeratosis

 ○ Subjects should avoid hot water, and clothing or activities that can cause friction on the skin

 ○ Moisturizing cream should be applied sparingly

● Padded gloves and open shoes with padded soles should be worn to relieve pressure points

Grade 1 any occurrence

● Continue preventive strategies and in addition:

 ○ Soak hands in cool water

 ○ Apply petroleum jelly to moist skin

● In the case of hyperkeratotic lesions, exfoliate the hands or feet and apply moisturizing cream immediately afterwards

Grade 2 or 3 any occurrence

● Continue supportive/management measures and add analgesic(s) for pain

 

● Dose modifications to study treatments per protocol guidance

  1. HFS: hand-foot syndrome, HFSR: hand-foot skin reaction.
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Trials

ISSN: 1745-6215