Dranitsaris and Lacouture developed a score for predicting the risk of a skin rash in a breast cancer patient treated with lapatinib and capecitabine. The authors are from Augmentium Pharma Consulting and Memorial Sloan-Kettering Cancer Center.
Patient selection: breast cancer treated with lapatinib and capecitabine
Outcome: skin rash Grade 2 or greater
Parameters:
(1) brain metastases at baseline
(2) total planned dose of capecitabine in grams
(3) concomitant use of a 5HT3 antiemetic (granisetron, ondansetron, palonesetron, tropisetron)
|
Parameter |
Finding |
Points |
|
brain metastases |
No |
0 |
|
|
Yes |
50 |
|
total planned dose of capecitabine |
|
<grams> |
|
concomitant therapy with 5HT3 antiemetic |
no |
0 |
|
|
yes |
100 |
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 150 or more
• The higher the score the greater the risk for a skin rash.
• A score > 40 was considered “high risk” (risk > 1.6%).
|
Score |
Risk (Observed) |
|
<= 20 |
0.7% |
|
21 to 30 |
1.0% |
|
31 to 40 |
1.9% |
|
> 40 |
6% |
|
Score |
Percent with Grade 2+ Rash |
|
0 to 50 |
(0.00088 * ((score)^2)) + (0.0052 * (score)) + 0.08 |
|
50 to 125 |
(0.00328 * ((score)^2)) - (0.3268 * (score)) + 10.72 |
|
> 125 |
> 21.4% |
Specialty: Hematology Oncology, Dermatology
