Adverse cutaneous toxicities by PD-1/PD-L1 immune checkpoint inhibitors: pathogenesis, treatment, and surveillance

Cutaneous and Ocular Toxicology, Journal Year: 2022, Volume and Issue: 41(1), P. 73 - 90

Published: Jan. 2, 2022

Introduction The therapeutic use of humanised monoclonal programmed cell death 1 (PD-1) (pembrolizumab, and nivolumab) ligand-1 (PD-L1) (atezolizumab, avelumab, durvalumab) immune checkpoint inhibitors (ICPi) as potent anticancer therapies is rapidly increasing. mechanism signalling anti-PD-1/PD-L1 involves triggering cytotoxic CD4+/CD8 + T activation subsequent abolition cancer cells which induces specific immunologic adverse events that are to these therapies. These drugs can cause numerous cutaneous reactions characterized the most frequent immune-related (irAEs). Majority irAEs range from non-specific eruptions detectible skin manifestations, may be self-limiting present acceptable toxicity profiles, while some produce life-threatening complications.Objective This review aims illuminate associated related used in oncology along with relevant mechanism(s) management.Areas covered Literature was searched using various databases including Pub-Med, Google Scholar, Medline. search mainly involved research articles, retrospective studies, case reports, clinicopathological findings. With this article, an overview therapy, well suggestions, have been provided, so their recognition at early stages could help better management would prevent treatment discontinuation.HIGHLIGHTSCutaneous effects prevalent induced by immune-checkpoint antibodies.Cutaneous toxicities manifest form maculopapular rash pruritus.More complications also occur, vitiligo, worsened psoriasis, lichenoid dermatitis, mucosal involvement (e.g. oral reaction), dermatomyositis, lupus erythematosus.Cutaneous manifestations Stevens-Johnson syndrome/toxic epidermal necrolysis (TEN).Dermatologic usually mild, readily manageable, rarely result significant morbidity.Adequate event lead prevention worsening lesions limit disruption.

Language: Английский

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Immune checkpoint inhibitors and the development of granulomatous reactions

Journal of the American Academy of Dermatology, Journal Year: 2018, Volume and Issue: 81(5), P. 1165 - 1175

Published: Aug. 6, 2018

Language: Английский

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Cutaneous lichenoid drug eruptions: A narrative review evaluating demographics, clinical features and culprit medications

Journal of the European Academy of Dermatology and Venereology, Journal Year: 2023, Volume and Issue: 37(5), P. 965 - 975

Published: Jan. 18, 2023

Abstract Cutaneous lichenoid drug eruptions (LDE) are adverse reactions (ADR) characterized by symmetric, erythematous, violaceous papules reminiscent but rarely fully characteristic of lichen planus (LP). We aimed to analyse the literature describing cases LDE within last 20 years provide additional insight into culprit drugs, typical latency onset eruption, spectrum clinical presentations, severity and management. A search was conducted in MEDLINE between January 2000 27 2021. The keywords ‘lichenoid rash’ eruption’ were used. Cases included if diagnosis made, drugs identified. total 323 with identified from 163 published case reports studies. mean patient age 58.5 (1 month 92 years), 135 patients (41.8%) female. Checkpoint inhibitors (CKI) most frequently reported (136 cases; 42.1%), followed tyrosine kinase (TKI) (39 12.0%) anti‐TNF‐α‐monoclonal antibodies (13 4.0%). initiation manifestation 15.7 weeks (range: 0.1–208 weeks). After discontinuing drug, median time resolution 14.2 0.71–416 One hundred thirty‐six (42.1%) treated topical, 54 (16.7%) systemic glucocorticoids. Overall, we conclude that, albeit rare, is challenging diagnose ADR induced mostly CKI, TKI, biologics. Treatment modalities resemble that planus, had be discontinued only 26%, which low compared other types reactions. This probably due risk aggravation (e.g. toxic epidermal necrolysis) continued benefit/risk ratio favouring as often cancer therapy.

Language: Английский

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Systemic Therapies for Advanced Melanoma

Dermatologic Clinics, Journal Year: 2019, Volume and Issue: 37(4), P. 409 - 423

Published: July 10, 2019

Language: Английский

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Cutaneous adverse reactions to anti–PD-1 treatment—A systematic review

Journal of the American Academy of Dermatology, Journal Year: 2020, Volume and Issue: 83(5), P. 1415 - 1424

Published: April 19, 2020

Language: Английский

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Granulomatous and Sarcoid-like Immune-Related Adverse Events following CTLA4 and PD1 Blockade Adjuvant Therapy of Melanoma: A Combined Analysis of ECOG-ACRIN E1609 and SWOG S1404 Phase III Trials and a Literature Review

Cancers, Journal Year: 2023, Volume and Issue: 15(9), P. 2561 - 2561

Published: April 29, 2023

Treatment with immune checkpoint inhibitors (ICIs) has been linked to granulomatous and sarcoid-like lesions (GSLs) affecting different organs. This study sought evaluate GSL incidence in patients high-risk melanoma treated cytotoxic T-lymphocyte antigen 4 (CTLA4) or programmed cell death 1 (PD1) blockade adjuvant therapy two clinical trials: ECOG-ACRIN E1609 SWOG S1404. Descriptions severity ratings were recorded.

Language: Английский

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Cutaneous Adverse Reactions of Anticancer Agents

Dermatologic Clinics, Journal Year: 2019, Volume and Issue: 37(4), P. 555 - 568

Published: July 27, 2019

Language: Английский

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Granulomatous Cutaneous Drug Eruptions: A Systematic Review

American Journal of Clinical Dermatology, Journal Year: 2020, Volume and Issue: 22(1), P. 39 - 53

Published: Oct. 27, 2020

Language: Английский

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Interstitial granulomatous dermatitis and granulomatous arteritis in the setting of PD‐1 inhibitor therapy for metastatic melanoma

Journal of Cutaneous Pathology, Journal Year: 2019, Volume and Issue: 47(1), P. 65 - 69

Published: Aug. 7, 2019

Checkpoint inhibition has become an important target in the management of malignant melanoma. As anti-CTLA4 inhibitors and anti-PD1 antibodies are increasingly utilized, reports immune-related adverse events (IRAEs) becoming more frequent. Common noted cutaneous IRAEs morbilliform, lichenoid, bullous, granulomatous, psoriasiform, eczematous eruptions. We report a case interstitial granulomatous dermatitis arteritis setting nivolumab (anti-PD1) monotherapy for metastatic There many different causes vasculitis, such as herpes virus infection, lymphoproliferative disorders, systemic inflammatory bowel disease. This adds to growing literature on due checkpoint inhibition.

Language: Английский

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Granulomatous/sarcoid‐like reactions in the setting of programmed cell death‐1 inhibition: a potential mimic of disease recurrence

Journal of Cutaneous Pathology, Journal Year: 2019, Volume and Issue: 47(2), P. 154 - 160

Published: Aug. 22, 2019

Nivolumab and pembrolizumab are humanized IgG4 monoclonal antibodies against programmed cell death 1 (PD-1). Although these agents effective in treating advanced melanoma, non-small-cell lung carcinoma, other types of cancers, various adverse events have been reported. Cutaneous particularly prevalent and, while granulomatous/sarcoid-like reactions uncommon, they increasingly recognized as immune-related associated with immune checkpoint inhibitors. Herein, we report two cases reaction foreign material, mimicking metastatic malignancy after PD-1 inhibitor treatment. Clinicians should be aware the existence cutaneous lesions perform biopsy if needed to prevent misdiagnosis unnecessary adjustments immunotherapy.

Language: Английский

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