Bacterial decolonisation of Staphylococcus aureus could effectively decrease the severity of radiation dermatitis and prevent moist desquamation in patients with breast or head-and-neck cancer who received radiotherapy. Moreover, this approach is safe, easy, and cost-effective, according to the authors.
Ms Yana Kost (Albert Einstein College of Medicine, NY, USA) and colleagues demonstrated that nasal colonisation with Staphylococcus aureus prior to radiotherapy is a predictor of grade ≥2 radiation dermatitis. Therefore, a randomised phase 2 trial (NCT03883828) was developed to compare a strategy of bacterial decolonisation with standard-of-care in patients (n=80) with breast cancer or head-and-neck cancer who were planned to receive fractionated radiotherapy (≥15 fractions) . Patients in the bacterial decolonisation arm received intranasal mupirocin ointment, twice daily, and chlorhexidine body wash, once daily, for 5 consecutive days prior to radiotherapy initiation. This strategy was repeated every other week for 5 days during radiotherapy.
The median radiation dermatitis grade was significantly lower in the bacterial decolonisation arm than in the standard-of-care arm (1.19 vs 1.58; P=0.019), meeting the primary endpoint of this trial. In addition, grade ≥2 moist desquamation could effectively be prevented by the bacterial decolonisation approach (0% vs 23.68%; P=0.002). Furthermore, the data showed that nasal Staphylococcus aureus colonisation rates were decreased in the bacterial decolonisation arm from baseline to post-radiotherapy (13.16% to 7.89%), whereas an opposite pattern was noted in the standard-of-care arm (15.79% to 23.68%). Despite these results, no significant differences in quality-of-life between the 2 patient groups were reported.
Ms Kost concluded that bacterial decolonisation was an effective strategy to reduce radial dermatitis severity and prevent moist desquamation in the study population. She argued that bacterial decolonisation is safe, easy, cost-effective, and avoids infection and skin atrophy, concerns that are associated with the use of topical steroids.
- Kost Y, et al. Bacterial decolonization to prevent acute radiation dermatitis: A randomized controlled trial. LBA12003, ASCO 2022 Annual Meeting, 3–7 June, Chicago, IL, USA.
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Letter from the Editor »
Table of Contents: ASCO 2022
Letter from the Editor
ASCO 2022 Highlights Podcast
Sacituzumab govitecan meets primary endpoint
Shaky OS results of palbociclib in ER-positive/HER2-negative breast cancer
Practice-changing results of T-DXd in HER2-low breast cancer
SET2,3 to inform on chemotherapy decisions in ER-positive breast cancer
Metastasis-directed therapy fails in oligometastatic breast cancer
Analysis by residual cancer burden further clarifies effect of pembrolizumab
Contribution of metastatic therapies on mortality reduction in breast cancer
Radiotherapy may be omitted in breast cancer patients
Promising data for ribociclib after progression on ET plus CDK4/6 inhibitors in HR-positive/HER2-negative metastatic breast cancer
7-gene biosignature: Benefits of endocrine therapy and radiotherapy in breast cancer risk groups
Additional tiragolumab does not help patients with untreated small cell lung cancer
Success for serplulimab plus chemotherapy in small cell lung cancer
Adagrasib safe and clinically active in non-small cell lung cancer
Long-term benefits of combined immunotherapy over chemotherapy in non-small cell lung cancer
Effect of KRAS mutations and PD-L1 expression on therapy response in non-small cell lung cancer
First results on distant metastasis-free survival in stage II melanoma
Higher response rates for concurrent triple therapy versus sequential therapy in melanoma
Exploratory treatment options fail in ccRCC
Adjuvant everolimus did not benefit high-risk renal cell carcinoma
Cabozantinib fails as first-line maintenance therapy in urothelial cancer
177Lu-PSMA-617 is a valid treatment option for PSMA-positive mCRPC
Enzalutamide performs well in metastatic hormone-sensitive prostate cancer
Autologous stem cell transplantation plus RVd improves PFS in multiple myeloma
Novel first-line treatment option for mantle cell lymphoma
Promising results for novel CAR-T therapy in relapsed/refractory multiple myeloma
Panitumumab beats bevacizumab in RAS wildtype left-sided metastatic colorectal cancer
Spectacular results for dostarlimab in mismatch repair deficient rectal cancer
Triplet chemotherapy beats doublet chemotherapy in colorectal cancer liver metastases
To resect or not to resect primary tumours in stage IV colon cancer?
Novel treatment option for KRAS wildtype pancreatic cancer
Primary results of rucaparib in ovarian cancer
Trabectedin not superior to chemotherapy in recurrent epithelial ovarian cancer
Encouraging results of relacorilant in ovarian cancer
Bacterial decolonisation effective against radiation dermatitis
New standard-of-care for cisplatin-ineligible locally advanced head and neck squamous cell carcinoma
Ifosfamide is likely to be the go-to therapy in recurrent Ewing sarcoma
Dabrafenib plus trametinib candidates for standard-of-care in BRAF V600-mutated paediatric low-grade glioma
Letter from the Editor