Immunohistochemical analysis of E-cadherin (ECad) and R-cadherin (RCad) in normal skin samples from breast cancer patients before starting capecitabine treatment. Unlike ECad (top), RCad (bottom) expression is mostly observed in the suprabasal epidermal layers, which are affected in the hand-foot syndrome. Credit: CNIO

Capecitabine is a chemotherapy drug used for breast and colorectal cancer. It can extend survival rate by nearly 10%. However, recent studies revealed that almost 50% of patients develop palmar-plantar erythrodysesthesia, a skin reaction also called hand-foot syndrome with mild to serious symptoms. Up to 17% of these patients can have a burning pain in their hands