Does Sunscreen Prevent Epidermal Growth Factor Receptor (EGFR) Inhibitor–Induced Rash? Results of a Placebo‐Controlled Trial from the North Central Cancer Treatment Group (N05C4)

Purpose. Rash occurs in >50% of patients prescribed epidermal growth factor receptor (EGFR) inhibitors. This study was undertaken to determine whether sunscreen prevents or mitigates these rashes. Methods. This placebo‐controlled, double‐blinded trial enrolled rash‐free patients starting an EGFR inhibitor. Patients were randomly assigned to sunscreen with a sun protection factor of 60 applied twice a day for 28 days versus placebo. They were then monitored for rash and quality of life (Skindex‐16) during the 4‐week intervention and for an additional 4 weeks. Results. Fifty‐four patients received sunscreen, and 56 received placebo; the arms were balanced at baseline. During the 4‐week intervention, physician‐reported rash occurred in 38 (78%) and 39 (80%) sunscreen‐treated and placebo‐exposed patients, respectively ( p = 1.00); no significant differences in rash rates emerged over the additional 4 weeks. There were no significant differences in rash severity, and patient‐reported outcomes of rash yielded similar conclusions. Adjustment for sun intensity by geographical zone, season, and use of photosensitivity medications did not yield a significant difference in rash across study arms ( p = .20). Quality of life scores declined but remained comparable between arms. Conclusions. Sunscreen, as prescribed in this trial, did not prevent or attenuate EGFR inhibitor–induced rash.