Vitiligo‐like depigmentation in oncology patients treated with immunotherapies for nonmelanoma metastatic cancers

Liu, R. C.; Consuegra, Germana; Chou, Shaun; Peñas, Pablo F.

doi:10.1111/ced.13867

Cited by 40 publications

(36 citation statements)

References 9 publications

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“…In 2017, Zarogoulidis et al reported a case of leukoderma during anti-PD-1 therapy of lung adenocarcinoma [124], and a second case was reported one year later [125] (Figure 3). Leukoderma lesions were also reported in two patients affected by renal cell carcinoma and in patients with cholangiocarcinoma or squamous cell carcinoma [126,127].…”

Section: Melanoma-associated Leukoderma Beyond Melanomamentioning

confidence: 85%

Melanoma and Vitiligo: In Good Company

Failla

Carbone

Fortes

et al. 2019

IJMS

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Cutaneous melanoma represents the most aggressive form of skin cancer, whereas vitiligo is an autoimmune disorder that leads to progressive destruction of skin melanocytes. However, vitiligo has been associated with cutaneous melanoma since the 1970s. Most of the antigens recognized by the immune system are expressed by both melanoma cells and normal melanocytes, explaining why the autoimmune response against melanocytes that led to vitiligo could be also present in melanoma patients. Leukoderma has been also observed as a side effect of melanoma immunotherapy and has always been associated with a favorable prognosis. In this review, we discuss several characteristics of the immune system responses shared by melanoma and vitiligo patients, as well as the significance of occurrence of leukoderma during immunotherapy, with special attention to check-point inhibitors.

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Section: Melanoma-associated Leukoderma Beyond Melanomamentioning

confidence: 85%

Melanoma and Vitiligo: In Good Company

Failla

Carbone

Fortes

et al. 2019

IJMS

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“…Almost all organ and system can be affected by irAEs, mainly skin, gastrointestinal tract and liver followed by lungs, nervous system, endocrine organs, joints, heart, pancreas and the kidneys ( 34 ). Thus, the most frequent ICIs-induced irAEs are dermatitis, rash, vitiligo, colitis, pneumonitis, hypophysitis, hypothyrodims, and other endocrinopathies ( 35 ). The incidence of irAEs is wide, ranging from 15% to 90%, with severe forms ranging from 0.5% to 13% ( 36 ).…”

Section: Immune-related Adverse Events (Iraes)mentioning

confidence: 99%

“…However, even if incidence of nephrotoxicity with monotherapy with any of the classes of ICIs was moderate, combinations including both an anti-CTLA-4, as well as an anti–PD-1, agent has been shown to be up to 5%. In particular, AKI was more common with combination therapy with ipilimumab/nivolumab combination therapy (4.9%) than with monotherapy with ipilimumab (2%), nivolumab (1.9%), or pembrolizumab (1.4%) alone ( 5 , 35 ).…”

Section: Immune-related Adverse Events (Iraes)mentioning

confidence: 99%

The Use of Immune Checkpoint Inhibitors in Oncology and the Occurrence of AKI: Where Do We Stand?

et al. 2020

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Immune checkpoint inhibitors (ICIs) are a novel class of immunotherapy drugs that have improved the treatment of a broad spectrum of cancers as metastatic melanoma, non-small lung cancer or renal cell carcinoma. These humanized monoclonal antibodies target inhibitory receptors (e.g. CTLA-4, PD-1, LAG-3, TIM-3) and ligands (PD-L1) expressed on T lymphocytes, antigen presenting cells and tumor cells and elicit an anti-tumor response by stimulating immune system. Nevertheless, the improved overall survival is complicated by the manifestation of Immune-related Adverse Effects (irAEs). During treatment with ICIs, the most common adverse kidney effect is represented by the development of acute kidney injury (AKI) with the acute tubulointerstitial nephritis as recurrent histological feature. The mechanisms involved in ICIs-induced AKI include the re-activation of effector T cells previously stimulated by nephrotoxic drugs (i.e. by antibiotics), the loss of tolerance versus self-renal antigens, the increased PD-L1 expression by tubular cells or the establishment of a pro-inflammatory milieu with the release of self-reactive antibodies. For renal transplant recipient treated with ICIs, the increased incidence of rejection is a serious concern. Therefore, the combination of ICIs with mTOR inhibitors represents an emerging strategy. Finally, it is relevant to anticipate which patients under ICIs would experience severe irAEs and from a kidney perspective, to predict patients with higher risk of AKI. Here, we provide a detailed overview of ICIs-related nephrotoxicity and the recently described multicenter studies. Several factors have been reported as biomarkers of ICIs-irAEs, in this review we speculate on potential biomarkers for ICIs-associated AKI.

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“…Moreover, tumor-infiltrating lymphocytes in these patients tend to skew towards CD8 + T-cell phenotype, along with increased production of interferon-γ (IFN-γ) and TNF-α [ 70 ]. Reports of vitiligo-like lesions developed after immune checkpoint therapy in patients with cancers other than melanoma are less common [ 73 ].…”

Section: Hypopigmentation As a Surrogate Marker Of Antitumor Immunmentioning

confidence: 99%

Hypopigmented Mycosis Fungoides: Loss of Pigmentation Reflects Antitumor Immune Response in Young Patients

Villarreal

Gantchev

Lagacé

et al. 2020

Cancers

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Hypopigmented mycosis fungoides (HMF) is a form of cutaneous T-cell lymphoma (CTCL), a heterogeneous group of extranodal non-Hodgkin’s lymphomas. HMF has a unique set of defining features that include light colored to achromic lesions, a predilection for darker skin phototypes, an early onset of disease, and predominance of CD8+ T-cells, among others. In the current review, we detail the known pathways of molecular pathogenesis for this lymphoma and posit that an active Th1/cytotoxic antitumor immune response in part explains why this variant is primarily seen in children/adolescents and young adults, who do not exhibit signs of immunosenescence. As a result of this potent cytotoxic response, HMF patients experience mostly favorable overall prognosis, while hypopigmentation may in fact represent a useful surrogate marker of cytotoxic immunity targeting the malignant cells. Understanding the molecular processes behind the specific features that define HMF may lead to improved diagnostic accuracy, personalized prognosis by risk stratification, and improved management of HMF. Moreover, improving our knowledge of HMF may aid our further understanding of other cutaneous lymphomas.

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Vitiligo‐like depigmentation in oncology patients treated with immunotherapies for nonmelanoma metastatic cancers

Cited by 40 publications

References 9 publications

Melanoma and Vitiligo: In Good Company

Melanoma and Vitiligo: In Good Company

The Use of Immune Checkpoint Inhibitors in Oncology and the Occurrence of AKI: Where Do We Stand?

Hypopigmented Mycosis Fungoides: Loss of Pigmentation Reflects Antitumor Immune Response in Young Patients

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