Vitamin K1: Help for cetuximab skin rashes in colorectal cancer patients?

This study assessed whether vitamin K1 creams can reduce the risk of skin rashes in patients taking cetuximab (Erbitux) for colorectal cancer.

The epidermal growth factor receptor (EGFR) protein is involved in cancer growth. Cetuximab is a treatment that blocks EGFR, slowing cancer growth. It is an effective treatment for patients with metastatic colorectal cancer (cancer that has spread from the colon or rectum to distant organs).

The majority of patients treated with cetuximab will develop skin rashes. For 10% to 20% of patients these skin effects are severe and can lead to treatment delays, reduced treatment dose, and breaks in treatment. Skin rashes can also affect patients’ quality of life. No treatments exist to prevent skin rashes and better treatments are needed for treating the rash. Vitamin K1-based skin creams may be useful for treating and preventing the rash.

The authors examined whether a vitamin K1 skin cream (Vigorskin; 0.1% vitamin K1) could prevent skin rashes in patients taking cetuximab. 41 patients with metastatic colorectal cancer who had not yet started treatment with cetuximab were given the vitamin K1 cream. Patients began using the cream on the first day of cetuximab treatment. They were told to apply the cream twice per day to their face and torso, once in the morning and once in the evening before bed. Skin effects were monitored after starting treatment.

On average patients developed their most severe skin rash after 34.7 days. During the first 8 weeks of treatment 6 patients (15%) had no skin rash, 18 patients (45%) had a mild skin rash, and 10 patients (25%) had a moderate skin rash. 6 patients (15%) had a severe skin rash within the first 8 weeks. The rate of moderate and severe skin effects were at the lower limits of rates reported in previous trials.

Patients with moderate or severe skin effects were treated with antibiotics. Patients with severe skin reactions also received steroids (such as hydrocortisone creams; 83% of patients) or antihistamines (such as Benedryl; 33% of patients). One patient stopped taking cetuximab during the study because their skin rash was so severe.

The vitamin K1 cream did not lead to any significant side effects.

The authors concluded that the vitamin K1 cream was safe and may reduce the risk of skin rash in colorectal cancer patients treated with cetuximab.

This was a relatively small study and did not include a comparison group who did not use the Vitamin K1 cream. Further research is needed to assess the usefulness of vitamin K1-based creams.