Management of the Cutaneous Adverse Effects of Antimelanoma Therapy

Abstract

The advent of targeted therapy and immunotherapy has revolutionized the management of advanced melanoma. However, these novel therapies are associated with adverse effects (AEs), of which cutaneous toxicities are the most frequently observed. These cutaneous AEs can exert significant morbidity and impact on patient quality of life, hence the recognition and management of AEs is fundamental in preventing interruption or cessation of survival-prolonging treatments. Additionally, knowledge of these AEs are necessary in order for healthcare professionals to counsel patients when starting treatment and in the initiation of AE prophylaxis. The incidence and clinical presentation of the cutaneous toxicities of novel melanoma therapies will be discussed, and treatment guidelines provided.

Cutaneous immune‐related adverse events in patients with melanoma treated with checkpoint inhibitors

“…32 Ideally, a multidisciplinary assessment involving dermatologist review is desirable for clinical diagnosis in each new case, which may include a skin biopsy and management tailored to the pertinent cutaneous IrAE. Several pragmatic guides have been proposed for treating oncologists, 30,[51][52][53] which include indications for stopping CPI therapy and suggested therapeutic strategies. These include the use of topical corticosteroids and antihistamine therapy.…”

Cutaneous side effects and types of dermatological reactions in metastatic melanoma patients treated by immunotherapies or targeted therapies: A retrospective single center study

“…The two most frequent toxicities observed in the target cohort were maculo‐papular eruption and pustular rash, according as well as in the literature 3 which reports generic rash as the most frequent BRAF‐inhibitor side effect and pustular eruption as the most frequent secondary to MEK‐inhibitors. Regarding the cohort treated by target therapy, we have also observed three cases of erythema nodosum, rarely reported.…”

“…However, these novel therapies are associated with adverse effects (AEs), of which cutaneous toxicities are the most frequently observed. These cutaneous AEs can exert significant morbidity and impact on patient quality of life, hence the recognition and management of AEs is fundamental in preventing interruption or cessation of survival‐prolonging treatments 3 . According to international guidelines, cutaneous adverse events are generically classified as rash or erythema in the majority of cases, without a specific dermatological classification 4 .…”

“…These cutaneous AEs can exert significant morbidity and impact on patient quality of life, hence the recognition and management of AEs is fundamental in preventing interruption or cessation of survival‐prolonging treatments. 3 According to international guidelines, cutaneous adverse events are generically classified as rash or erythema in the majority of cases, without a specific dermatological classification. 4 However, a series of studies and literature review have clearly shown that cutaneous manifestations associated with immunotherapy or target therapy can present with different clinical features.…”