[Pigmentary disorders induced by anticancer agents. Part II: targeted therapies]

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Targeted anticancer therapies are increasingly used in cancer treatment.
• Dermatological toxicities are common and often the most prominent side effects of these drugs.
• Pigmentary changes, particularly depigmentation, are characteristic toxicities.

Purpose of the Study:

• To review the main pigmentary disorders associated with targeted anticancer therapies.
• To describe the spectrum of pigmentary changes affecting skin, hair, nails, and mucous membranes.
• To correlate specific pigmentary changes with different classes of targeted agents.

Main Methods:

• Literature review of studies on dermatological toxicities of targeted anticancer therapies.
• Analysis of reported pigmentary changes including hyperpigmentation, hypopigmentation, and other specific manifestations.
• Categorization of pigmentary disorders based on the targeted drug class (e.g., MEK inhibitors, EGFR inhibitors, TKIs, RAF inhibitors, CTLA4/PD1/PD-L1 blockers).

Main Results:

• Hyperpigmentation is associated with MEK or EGFR inhibitors.
• Hypopigmentation is observed with tyrosine kinase inhibitors like imatinib, sunitinib, and pazopanib.
• Other pigmentary changes include blue dots (vandetanib), eruptive nevi (RAF inhibitors), and vitiligoid reactions (CTLA4/PD1/PD-L1 blockers).

Conclusions:

• Targeted anticancer therapies induce a range of pigmentary disorders affecting various cutaneous and mucosal sites.
• Understanding these specific toxicities is crucial for managing patients undergoing these treatments.
• The pattern of pigmentary change can be indicative of the specific targeted agent used.