Taking it in the chin: vitamin K1 for the prevention of acneiform rash

In this issue of Annals of Oncology, Hofheinz et al. study the efficacy of a topical formulation of vitamin K1 in the prevention of a disfiguring toxicity resulting from epidermal growth factor receptor (EGFR) inhibitors [1]. An acneiform rash on the face and upper body develops in the majority of patients treated with EGFR inhibitors [2]. In addition to its psychosocial impact [3], it is associated with symptoms of pruritus and pain, may result in secondary infections [4], all of which may lead to inconsistencies in the dosing of causal anticancer agents [5]. Since the rash has been correlated with antitumor efficacy across most solid tumors in which it has been employed [6], mitigating this untoward event has been the subject of research for the past 15 years.