Clinical Scorecard: Incidence, Clinical Features, and Contributing Factors of Capecitabine-Related Hand–Foot Syndrome in Cancer Patients: Insights from Sudan

At a Glance

Key Highlights

• More than 50% of Sudanese cancer patients on capecitabine develop HFS, impacting quality of life and treatment adherence.
• Female sex and multiple chemotherapy cycles were associated with lower HFS incidence; absence of comorbidities increased risk.
• Use of both NCI Common Terminology Criteria and a modified grading scale for Black patients improves HFS severity assessment.

Guideline-Based Recommendations

Diagnosis

• Use standardized grading systems such as NCI Common Terminology Criteria for Adverse Events for HFS severity assessment.
• Apply modified grading scales tailored for darker skin tones to improve diagnostic accuracy in Black patients.

Management

• Early recognition and timely management of HFS to improve patient quality of life and maintain cancer treatment continuity.
• Educate patients on signs and symptoms of HFS to facilitate prompt reporting and intervention.

Monitoring & Follow-up

• Regular clinical evaluation during chemotherapy cycles to detect onset and progression of HFS.
• Monitor patients especially those without concomitant diseases, as they have higher risk of developing HFS.

Risks

• Higher risk of HFS in patients without concomitant diseases.
• Ethnic and genetic factors may influence susceptibility to HFS.

Patient & Prescribing Data

Adult Sudanese cancer patients receiving capecitabine monotherapy at a national oncology center

Capecitabine monotherapy is associated with a high incidence of HFS; risk factors include absence of comorbidities and male sex; multiple chemotherapy cycles may reduce risk.

Clinical Best Practices

• Restrict capecitabine monotherapy studies to isolate its specific contribution to HFS development.
• Incorporate patient education on HFS symptoms and preventive measures as part of chemotherapy protocols.
• Use dual grading systems for HFS severity to accommodate skin tone variations and improve clinical assessment.
• Perform multivariable logistic regression analyses to identify independent risk factors for HFS.

References

• World Health Organization and National Cancer Institute grading systems for HFS
• NCI Common Terminology Criteria for Adverse Events (CTCAE)