Preventive and Therapeutic Interventions for Anticancer Drug-induced Dermatologic Toxicities: a Scoping Review

PURPOSE OF REVIEW: Anticancer drug-induced dermatologic toxicities frequently compromise quality of life and treatment adherence. While diverse strategies have been investigated, evidence patterns across drug classes remain unclear. This scoping review aimed to systematically map clinical studies evaluating preventive and therapeutic interventions for dermatological toxicities-specifically EGFR inhibitor-associated rash, capecitabine-induced hand-foot syndrome (HFS), and multikinase inhibitor-associated hand-foot skin reaction (HFSR)-using a mechanism- and outcome-based framework. RECENT FINDINGS: Based on the analysis of 51 clinical studies, distinct evidence patterns emerged. For EGFR inhibitor-associated rash, prophylactic strategies using tetracycline- or macrolide-based antibiotics combined with topical corticosteroids consistently reduced grade ≥ 2 events. In capecitabine-induced HFS, both systemic and topical COX-2 inhibition significantly reduced grade ≥ 2 toxicity, while methylcobalamin showed phase III efficacy. For HFSR, barrier reinforcement, COX-2 inhibition, and high-potency corticosteroids were effective. Mechanism-based mapping revealed specific pathophysiological profiles: inflammatory-epithelial for EGFR rash, inflammatory-neuropathic for HFS, and mechanical-vascular-inflammatory for HFSR. Dermatological toxicities associated with anticancer therapies show clear mechanistic divergence and require toxicity-specific preventive strategies. Rather than a one-size-fits-all approach, mechanism-driven and toxicity-specific supportive care represents the most rational and effective strategy for managing these adverse events.