Clinical profile of cutaneous adverse events of immune checkpoint inhibitors in a single tertiary center

Abstract

Programmed death 1 (PD‐1)/programmed death ligand 1 (PD‐L1) inhibitors have demonstrated their efficacy in the treatment of various malignancies. Despite their benefits, their immunomodulatory activities can cause unpredictable cutaneous adverse events (CAE). This study aimed to identify characteristics of CAE in patients treated with PD‐1/PD‐L1 inhibitors through the medical records, photographs, and pathology reports. Fifty CAE occurred in 47 (2.75%) of 1711 patients treated with PD‐1/PD‐L1 inhibitors. Pruritic, psoriasiform, urticarial, and acneiform eruptions were the four most common types. Melanoma patients showed CAE more frequently than other malignancies. Acneiform eruption occurred more often at ages under 60 years. Urticarial eruption appeared earlier, while keratoacanthoma appeared later after immunotherapy. The overall survival times were not significantly different between the two groups with and without CAE by Kaplan–Meier analysis (p = 0.055). Studies on CAE may provide more information to understand these drugs and to help manage the patients.

Immune checkpoint inhibitor-related adrenal hypofunction and Psoriasisby induced by tislelizumab: A case report and review of literature

“…[ 23 ] A Korean retrospective analysis found that melanoma and genitourinary malignancies were most likely to experience cutaneous adverse reactions following the use of PD-1/PD-L1 inhibitors; pruritic, psoriatic, and urticaria are the most common types of rash, with median times of appearance of 15, 20, and 6.5 weeks respectively; urticaria appeared earlier after immunotherapy, while keratoacanthoma appeared later. [ 24 ]…”

“…[23] A Korean retrospective analysis found that melanoma and genitourinary malignancies were most likely to experience cutaneous adverse reactions following the use of PD-1/PD-L1 inhibitors; pruritic, psoriatic, and urticaria are the most common types of rash, with median times of appearance of 15, 20, and 6.5 weeks respectively; urticaria appeared earlier after immunotherapy, while keratoacanthoma appeared later. [24] A retrospective analysis of tislelizumab in combination with gemcitabine plus cisplatin as first-line treatment for locally advanced or metastatic BCa suggested that the most common TRAEs were anemia (57.1%), decreased appetite (57.1%), nausea/vomiting (50.0%), and thyroid disorders (42.9%). The reported rate of rash was 14.3%.…”

Acneiform eruption induced by molecularly targeted agents in antineoplastic therapy: A review

“…More than 88% [4][5][6] TKIs Gefitinib, erlotinib, lapatinib, afatinib 43%-75% 4,5,7,8 Her2 inhibitor Trastuzumab，pertuzumab about25% 9 VEGFRI Bevacizumab, aflibercept present RAS / RAF / MEK / ERK inhibitor BRAF inhibitor Vemurafenib，dabrafenib 3%-9% 10,11 MEK inhibitor Trametinib 74%-89% 11,12 Combination of BRAF and MEK inhibitors 14%-40% 11,13 Multikinase inhibitors Sorafenib, sunitinib Present 10 mTOR inhibitor Everolimus, sirolimus 15%-49% 12 PD-1/PD-L1 inhibitor Nivolumab, Pembrolizumab 0.3%-8% 8,14,15 CTLA-4 inhibitor Ipilimumab, tremelimumab 2.4%-7.3% 16 Note: Present = event has been reported, but the frequency is unknown. As BRAF, MEK, and mTOR are all downstream molecules of EGFR signaling, inhibition of these molecules can result in similar reactions.…”