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EGFR inhibitors are associated with a 52.30% pooled incidence of all-grade rash in patients with tumorsEGFR inhibitors linked to rash in over half of patients

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Key Takeaway
Note a 52.30% incidence of all-grade rash with EGFRIs, especially in Asian populations and combination therapies.

This meta-analysis evaluated the incidence of skin reactions in 65,116 patients treated with epidermal growth factor receptor inhibitors (EGFRIs). The analysis focused on all-grade rash and high-grade rash as primary safety outcomes. The study utilized a trim-and-fill method to ensure the reliability of the pooled results.

The meta-analysis reported a 52.30% pooled incidence for all-grade rash (95% CI: 48.70%-55.80%). High-grade rash was observed in 9.50% of cases (95% CI: 8.70%-10.30%). Subgroup analyses indicated increased risks associated with Asian populations, the use of EGFR monoclonal antibodies, phase III clinical trials, and combination therapies. Conversely, Aumolertinib showed a significantly lower relative risk for rash.

While specific limitations were not reported, the findings suggest that clinicians should consider proactive management strategies for high-risk groups. Specifically, patients who are Asian or receiving EGFR monoclonal antibodies in combination with radiotherapy and chemotherapy may require earlier intervention to manage skin reactions.

A new analysis of 65,116 patients with tumors who were treated with epidermal growth factor receptor inhibitors (EGFRIs) found that these drugs are linked to a high rate of rash. The study, which combined results from many clinical trials, reported that 52.30% of patients experienced any rash, and 9.50% had a high-grade rash, which can be severe. The findings were published as a meta-analysis, a type of study that pools data from multiple studies to get a more reliable estimate.

The analysis also looked at specific groups. It found that the risk of rash was higher in Asian patients, in those using EGFR monoclonal antibodies (a type of EGFRI), in phase III clinical trials, and when EGFRIs were combined with other treatments. However, one drug, Aumolertinib, had a significantly lower risk of rash compared to others. The type of tumor and the year of publication did not affect the rash risk.

Rash is a common side effect of EGFRIs, and while it is not usually life-threatening, it can be uncomfortable and affect quality of life. The study did not report on serious adverse events or how many patients stopped treatment due to rash.

Because this is a meta-analysis, it provides strong evidence, but it is important to remember that the results are based on pooled data and may not apply to every individual. The researchers suggest that for Asian patients using EGFR monoclonal antibodies in combination with radiotherapy and chemotherapy, early prevention and treatment of rash could be considered. However, this is not a recommendation for individual patients; always talk to your doctor about your specific situation.

What this means for you:
EGFR inhibitors often cause rash, especially in Asian patients; talk to your doctor if you're concerned.

Common questions

What is the risk of rash with EGFR inhibitors?

In this analysis of 65,116 patients, 52.30% developed any rash and 9.50% had a high-grade rash. The risk was higher in Asian patients and with certain types of EGFR inhibitors.

Who is more likely to get a rash from EGFR inhibitors?

The analysis found that Asian patients, those using EGFR monoclonal antibodies, and those in phase III clinical trials had a higher risk. Also, combining EGFRIs with other treatments increased the risk.

Is the rash from EGFR inhibitors serious?

Most rashes are not high-grade, but 9.50% of patients had a high-grade rash, which can be severe. The study did not report on serious adverse events or treatment discontinuations due to rash.

Does the type of tumor affect rash risk?

No, the type of tumor did not have a significant effect on the incidence of rash. The risk was similar across different tumor types in this analysis.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedAug 2026
View Original Abstract ↓
BackgroundRashes in patients treated with epidermal growth factor receptor inhibitors (EGFRIs) are closely related to better clinical outcomes. Multiple randomized controlled trials have evaluated rashes caused by EGFRIs. We conducted a meta-analysis of patients with tumors receiving EGFR-targeted therapy to determine the incidence and relative risk of rashes associated with these drugs.MethodsFour databases (PubMed, Web of Science, Embase, and Cochrane) were systematically searched to find randomized controlled trials reporting the incidence of rash associated with EGFRIs from the time of database construction to May 15, 2025. Meta-analysis was used to calculate the total incidence and relative risk (RR) of all grades or each grade of rash.ResultsA total of 65,116 patients from 194 studies were included. The pooled incidences of all-grade rash and high-grade rash associated with EGFRIs were 52.30% (95% CI: 48.70%-55.80%) and 9.50% (95% CI: 8.70%-10.30%), respectively. The pooled RR suggested that EGFRIs were associated with a significantly increased risk of rash. Subgroup analysis and regression analysis showed that Asian populations, EGFR monoclonal antibodies (EGFR mAbs), phase III clinical trials, and EGFRI combination therapy may increase the occurrence of rash, whereas Aumolertinib had a significantly lower RR of rash. The type of tumor and the year of publication had no significant effect on the incidence of rash. The trim-and-fill method indicated that the results were reliable.ConclusionsEGFRIs have a high possibility of increasing the risk of rashes. Prevention and early treatment of rashes could be performed earlier for Asian patients who use EGFR mAbs in combination with radiotherapy and chemotherapy.System Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/, identifier CRD420251039464.
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