To describe outcomes with topical delgocitinib in two patients with capecitabine-associated hand–foot syndrome (HFS) that persisted despite urea and high-potency topical corticosteroids.
Approach:
Patients: Two patients with metastatic breast cancer and grade 3 HFS while receiving capecitabine were treated after only transient improvement with clobetasol 0.05% and urea 30%.
Treatment and assessment: Both applied delgocitinib twice daily to the palms and soles for 6 weeks. HFS was assessed clinically using CTCAE grade and the HFS-14 quality-of-life score.
Key Findings:
One patient improved from CTCAE grade 3 to grade 1, with HFS-14 decreasing from 73.5 to 17.6; capecitabine could be continued.
The other patient remained at CTCAE grade 3, with HFS-14 decreasing from 76.5 to 67.6; capecitabine interruption was required.
Interpretation:
The two patients had discordant outcomes. This limited case series cannot establish delgocitinib efficacy for capecitabine-associated HFS.
Limitations:
Only two patients were reported.
The outcomes differed between patients.
The report provides preliminary observations rather than evidence from a prospective controlled study.
Conclusion:
The authors state that larger prospective studies are needed to define the role of topical JAK inhibitors in HFS and identify patients more likely to benefit.
