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Characterization of dermatitis after PD-1/PD-L1 inhibitor therapy and association with multiple oncologic outcomes: A
Charles Kyung Min Lee1, Shufeng Li2, Duy Cong Tran1
1Stanford University School of Medicine, Redwood City, California.
Background:
Cutaneous adverse events are common with programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors. However, the nature of the specific cutaneous adverse event of dermatitis has not been investigated across various PD-1/PD-L1 inhibitors. Oncologic outcomes potentially associated with dermatitis are not well characterized.
Objective:
To assess the nature of dermatitis after exposure to a PD-1/PD-L1 inhibitor and oncologic outcomes associated with dermatitis.
Methods:
Retrospective, matched, case-control study conducted at a single academic center.
Results:
The most common histologic patterns were lichenoid dermatitis (50%) and spongiotic dermatitis (40%). The overall tumor response rate was 65.0% for the case patients and 17.0% for the controls (P = .0007) (odds ratio, 7.3; 95% confidence interval, 2.3-23.1). The progression-free survival and overall survival times were significantly longer for the case patients than for the controls by Kaplan-Meier analysis (P < .0001 and .0203, respectively).
Limitations:
The retrospective design and relatively small sample size precluded matching for all cancer types.
Conclusions:
Lichenoid and spongiotic dermatitis associated with PD-1/PD-L1 inhibitors could be a sign of robust immune response and improved oncologic outcomes. The value of PD-1/PD-L1-related dermatitis in predicting cancer outcomes awaits investigation through prospective multicenter studies for specific cancer types.
Insights
Dermatitis from programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors may indicate a strong immune response. This immune response is associated with significantly improved cancer outcomes, including tumor response and survival.
Area of Science:
- Oncology
- Dermatology
- Immunology
Background:
- Cutaneous adverse events are frequent with PD-1/PD-L1 inhibitors.
- Dermatitis is a common adverse event, but its characteristics and impact on cancer outcomes are not well understood.
- Investigating dermatitis can provide insights into immune response and treatment efficacy.
Purpose of the Study:
- To characterize dermatitis in patients receiving PD-1/PD-L1 inhibitors.
- To evaluate the association between dermatitis and oncologic outcomes.
- To explore the potential of dermatitis as a predictive biomarker for cancer treatment.
Main Methods:
- Retrospective, matched, case-control study.
- Single academic center.
- Analysis of histologic patterns of dermatitis and correlation with tumor response, progression-free survival, and overall survival.
Main Results:
- Lichenoid dermatitis (50%) and spongiotic dermatitis (40%) were the most common histologic findings.
- Patients with dermatitis showed a significantly higher overall tumor response rate (65.0% vs 17.0%).
- Progression-free and overall survival were significantly longer in patients who developed dermatitis.
Conclusions:
- Dermatitis associated with PD-1/PD-L1 inhibitors, particularly lichenoid and spongiotic types, may signal a robust immune response.
- This immune response appears to correlate with improved oncologic outcomes.
- Prospective, multicenter studies are needed to validate PD-1/PD-L1-related dermatitis as a predictor of cancer outcomes.
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