A Novel Spectroscopically Determined Pharmacodynamic Biomarker for Skin Toxicity in Cancer Patients Treated with Targeted Agents

Cancer Res. 2017 Jan 15;77(2):557-565. doi: 10.1158/0008-5472.CAN-16-1733. Epub 2016 Nov 11.

Abstract

Raman spectroscopy is a noninvasive and label-free optical technique that provides detailed information about the molecular composition of a sample. In this study, we evaluated the potential of Raman spectroscopy to predict skin toxicity due to tyrosine kinase inhibitors treatment. We acquired Raman spectra of skin of patients undergoing treatment with MEK, EGFR, or BRAF inhibitors, which are known to induce severe skin toxicity; for this pilot study, three patients were included for each inhibitor. Our algorithm, based on partial least squares-discriminant analysis (PLS-DA) and cross-validation by bootstrapping, discriminated to variable degrees spectra from patient suffering and not suffering cutaneous adverse events. For MEK and EGFR inhibitors, discriminative power was more than 90% in the viable epidermis skin layer; whereas for BRAF inhibitors, discriminative power was 71%. There was a 81.5% correlation between blood drug concentration and Raman signature of skin in the case of EGFR inhibitors and viable epidermis skin layer. Our results demonstrate the power of Raman spectroscopy to detect apparition of skin toxicity in patients treated with tyrosine kinase inhibitors at levels not detectable via dermatological inspection and histological evaluation. Cancer Res; 77(2); 557-65. ©2016 AACR.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Algorithms*
  • Antineoplastic Agents / adverse effects*
  • Area Under Curve
  • Biomarkers / analysis
  • Drug Eruptions / diagnosis*
  • Erlotinib Hydrochloride / adverse effects
  • Female
  • Humans
  • Imidazoles / adverse effects
  • Indoles / adverse effects
  • Male
  • Middle Aged
  • Oximes / adverse effects
  • Pilot Projects
  • Protein Kinase Inhibitors / adverse effects
  • Pyridones / adverse effects
  • Pyrimidinones / adverse effects
  • ROC Curve
  • Sensitivity and Specificity
  • Skin / chemistry*
  • Skin / pathology
  • Spectrum Analysis, Raman / methods*
  • Sulfonamides / adverse effects
  • Vemurafenib

Substances

  • Antineoplastic Agents
  • Biomarkers
  • Imidazoles
  • Indoles
  • Oximes
  • Protein Kinase Inhibitors
  • Pyridones
  • Pyrimidinones
  • Sulfonamides
  • Vemurafenib
  • trametinib
  • Erlotinib Hydrochloride
  • dabrafenib