Anti-EGFR antibody therapy and skin toxicity: Retrospective analysis and role of pharmacists in protocol-based pharmacotherapy management

OBJECTIVE: Anti-epidermal growth factor receptor (EGFR) antibodies are a therapy option for patients with advanced or recurrent colorectal cancer. However, these agents frequently cause skin toxicities, which compromise treatment continuity and negatively impact patient quality of life, and evidence regarding pharmacist-led interventions remains limited. We aimed to evaluate pharmacist-led pre-consultation interviews for patients receiving anti-EGFR antibodies by examining pharmacist-physician concordance in skin toxicity assessment, physician acceptance of pharmacist recommendations, and their contribution to dermatological toxicity management and multidisciplinary care. MATERIALS AND METHODS: We conducted a retrospective observational study in 95 patients with colorectal cancer who received anti-EGFR antibody therapy in an outpatient setting between November 2012 and November 2023. Data collected included i) implementation status of pharmacist-led pre-consultation interviews, ii) concordance rates with physicians in skin toxicity grading, iii) acceptance rates of pharmacist-initiated prescriptions, and iv) physician adoption of recommendations regarding dose modifications or dermatology referrals. RESULTS: A total of 1,749 pharmacist-led pre-consultation interviews were conducted, achieving an implementation rate of 96.5%. Concordance rates between pharmacists and physicians for skin toxicity grading were approximately 98 - 99%, and the acceptance rate of pharmacist-initiated prescriptions exceeded 97%. Over 80% of the recommendations for dose adjustments and dermatology consultations were accepted. CONCLUSION: Pharmacist-led pre-consultation interviews facilitate accurate assessment and timely intervention for skin toxicities and serve as a practical tool to support physicians in treatment decision-making.