INDIVIDUAL ARTICLE: USCOM V: A Practical Algorithm for the Prevention and Treatment of Cutaneous Side Effects of Hormonal Cancer Therapy
April 2025 | Volume 24 | Issue 4 | 84821s3 | Copyright © April 2025
Published online March 31, 2025
Jennifer N. Choi MDa, Mario Lacouture MD FAADb, Anneke Andriessen PhDc, Alice Ho MD MBAd, Beth McLellan MDe, Edith Mitchell MD MACP FCPP FRCPf †, Jonathan Leventhal MDg
aDivisions of Oncodermatology and Medical Dermatology, Robert H. Lurie Comprehensive Cancer Center Northwestern University Feinberg School of Medicine, Chicago, IL
bDivision of Dermatology, NYU Grossman Long Island School of Medicine, Mineola, NY
cRadboud UMC Nijmegen and Andriessen Consultants, Malden, The Netherlands
dBreast Clinical Research Unit, Duke Cancer Institute, Professor of Radiation Oncology, Durham, NC
eDepartment of Dermatology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY; Department of Supportive Oncodermatology, Montefiore-Einstein Cancer Center, Bronx, NY
fDepartment of Medical Oncology, Center to Eliminate Cancer Disparities, Sidney Kimmel Cancer Center at Jefferson, Philadelphia, PA
gOnco-Dermatology Program, Smilow Cancer Hospital, Yale New Haven, New Haven, CT
Abstract
Introduction: In 2024, over 2 million patients will be diagnosed with cancer in the United States, with prostate cancer and breast cancer representing the leading diagnoses in men and women, respectively. Hormonal therapy is a mainstay treatment for hormone-dependent cancers but is associated with cutaneous adverse events. These include accelerated signs of aging, xerosis and pruritus, brittle nails, androgenic alopecia, and hirsutism. All clinicians involved in the care of these patients play an essential role in managing treatment-related cutaneous adverse events to minimize the burden on patients and improve their quality of life.
Objectives: To develop a multidisciplinary, physician-developed algorithm to guide the care of patients who develop cutaneous hormonal therapy-related adverse events.
Methods: A panel of advisors was selected, and a systematic literature review generated evidence to develop a treatment algorithm for managing cutaneous hormonal therapy-related adverse events via a modified Delphi process. The algorithm was developed based on the assembled evidence coupled with the panel's experience and opinion.
Results: An algorithm that tailors the prevention and management of cutaneous hormonal therapy-related adverse events in cancer patients used the CTCAE v.5 grading of cancer therapy-related skin disorders. Suggested management recommendations supplement the algorithm.
Conclusions: Prevention, recognition, and treatment of cutaneous hormonal therapy-related adverse events through the use of a physician-developed algorithm may limit treatment interruption, improve patient outcomes, and optimize the quality of life in patients on hormonal cancer therapy.
J Drugs Dermatol. 2025;24:4(Suppl 2):s3-14.
INTRODUCTION
In 2024, an estimated 2,001,140 new cancer cases and 611,720 cancer deaths are projected to occur in the United States.1 Hormone-dependent cancers, such as breast cancer and prostate cancer, are responsible for most new cancer cases. Breast cancer is the leading cancer diagnosis among women, with an estimated 310,720 women and 2,790 men expected to be diagnosed with breast cancer in 2024. Meanwhile, prostate cancer is the leading cancer diagnosis among men and the second most common diagnosis overall, with 299,010 expected cases.2
Although cancer incidence continues to rise, advancements in treatment options have contributed to the decline in cancer mortality.1,3 Hormonal therapy is a mainstay treatment for the management of hormone-dependent cancers. In breast cancer, hormonal therapy often involves reducing estrogen levels or blocking estrogen receptors. For prostate cancer, therapy typically aims to lower testosterone levels or block its effects through androgen deprivation therapy or antiandrogens.
