Improvement of classical therapy in EGFR inhibitors-induced cutaneous adverse reaction by microneedle delivery and Astragalus polysaccharide

EGFR (epidermal growth factor receptor) inhibitors, as the first-line drugs of targeted therapy, often cause additional distress for patients due to the induced cutaneous adverse reactions (EICAR), while classical therapies represented by topical minocycline and epidermal growth factor have limitations especially for exacerbating immune imbalance. Here, we used Astragalus polysaccharide (APS), which has modulatory effects on both the epidermis and the immune system, as an adjuvant drug to reduce EICAR and achieve immune balance. APS, combined with minocycline or epidermal growth factor, was delivered by dissolvable microneedles (MN), a novel drug delivery method that penetrates the stratum corneum to deliver the drug directly into the skin tissue. The results demonstrated that this therapy with the developed MN system not only restored local epidermal conditions, but also reestablished the balance of immune cells. Significantly, the addition of APS also promoted the alleviation of EICAR in non-treated areas, suggesting that local administration can result in systemic effects. The application of APS and the MN delivery system can provide new strategy for clinical treatment of EICAR and potential solutions for other skin diseases.