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Epirubicin-cyclophosphamide (EC) and fluorouracil-epirubicin-cyclophosphamide (FEC),2 epirubicin-based regimens,are often switched to docetaxel (DOC) in chemotherapy before and after breast surgery.As nail discoloration had been frequently observed during these breast cancer chemotherapy regimens,we investigated adverse drug events in nails.Drug adverse events were observed in the nails of 87% of patients treated with EC,in 83% treated with FEC,and 58% treated with DOC following the switch from EC or FEC.With regard to the time of onset,most nail discoloration appeared after second or third course of chemotherapy with EC or FEC.Adverse drug events differed depending on the chemotherapy regimen.Nail discoloration was nearly all specific to EC and FEC and nail bed pain,onycholysis,and koilonychias tended to occur with DOC.Though most adverse drug events in the nails were mild,any of Grade 2 (CTCAE v 3.0) occurring would have impaired quality of life and caused psychological stress.Therefore,pharmacists should inform patients receiving these chemotherapies of the possibility of adverse drug events in the nails and observe them carefully.They should also recommend consultation with a dermatologist as early as possible if Grade 2 adverse drug events should occur

Investigation of Adverse Drug Events in Nails during Breast Cancer Chemotherapy