Diverse types of dermatologic toxicities from immune checkpoint blockade therapy

Area of Science:

• Oncology
• Dermatology
• Immunology

Background:

• Cancer immunotherapies targeting CTLA-4 and PD-1/PD-L1 have significantly improved patient survival in advanced solid tumors.
• Dermatologic toxicity (DT) is a common adverse effect associated with these immunotherapies.
• Understanding the spectrum of DT is essential for managing patients undergoing cancer immunotherapy.

Purpose of the Study:

• To review and categorize the dermatologic toxicities associated with cancer immunotherapies.
• To highlight the incidence of DT in patients treated with anti-PD-1 and anti-PD-L1 agents.
• To emphasize the importance of early recognition and management of immunotherapy-induced DT.

Main Methods:

• Review of published reports on dermatologic toxicity in patients receiving immunotherapy.
• Analysis of DT incidence in patients treated with anti-PD-1 (n=3825) and anti-PD-L1 (n=556) antibodies.
• Categorization of observed DT into four main groups: inflammatory, immunobullous, alteration of keratinocytes, and alteration of melanocytes.

Main Results:

• Dermatologic toxicity was reported in approximately 39% of patients receiving anti-PD-1 and 17% receiving anti-PD-L1.
• Specific DT types, including lichenoid dermatitis and bullous pemphigoid, are notably associated with anti-PD-1/PD-L1 therapies.
• The dermatologic toxicity profile associated with immunotherapy is diverse.

Conclusions:

• Dermatologic toxicity is a frequent complication of cancer immunotherapy.
• Categorizing DT aids in understanding and managing these side effects.
• Prompt identification of specific DT subtypes is critical for effective patient management and optimal care.