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Cutaneous adverse reactions to anti-PD-1 treatment-A systematic review
Anne Birgitte Simonsen1, Jeanette Kaae1, Eva Ellebaek2
1Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
Abstract:
The use of the humanized monoclonal anti-programmed cell death 1 antibodies pembrolizumab and nivolumab as potent anticancer therapies is rapidly increasing. However, since their approval, numerous cases of cutaneous reactions have been reported. Cutaneous adverse reactions to these agents have yet to be fully characterized and range from nonspecific eruptions to recognizable skin manifestations, which may be localized and vary from mild to life threatening. This systematic review article provides an overview of the various adverse cutaneous reactions to pembrolizumab and nivolumab therapy and offers suggestions for their management.
Insights
Pembrolizumab and nivolumab are increasing cancer treatments, but can cause skin reactions. This review details these cutaneous adverse events and suggests management strategies.
Area of Science:
- Oncology
- Immunology
- Dermatology
Background:
- Monoclonal antibodies targeting programmed cell death 1 (PD-1), such as pembrolizumab and nivolumab, are increasingly utilized as cancer therapies.
- Despite their efficacy, a significant number of cutaneous adverse reactions have been documented following their administration.
- These skin reactions are diverse, ranging from common rashes to severe, potentially life-threatening manifestations.
Purpose of the Study:
- To systematically review and characterize the spectrum of adverse cutaneous reactions associated with pembrolizumab and nivolumab therapy.
- To provide an overview of the various skin manifestations observed.
- To offer evidence-based suggestions for the clinical management of these dermatologic toxicities.
Main Methods:
- Systematic literature review of reported cutaneous adverse events.
- Analysis of clinical presentations and characteristics of skin reactions.
- Synthesis of management strategies from published case reports and reviews.
Main Results:
- A wide range of cutaneous reactions were identified, including nonspecific eruptions and specific dermatoses.
- Reactions varied in severity from mild to life-threatening.
- The timing and presentation of reactions were diverse, requiring careful monitoring.
Conclusions:
- Adverse cutaneous reactions are a common and important toxicity of PD-1 inhibitors like pembrolizumab and nivolumab.
- Early recognition and appropriate management are crucial for patient safety and treatment continuation.
- Further research is needed to fully understand the mechanisms and optimize treatment protocols for these reactions.
