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Dermatologic infections in cancer patients treated with checkpoint inhibitors

Mytrang H Do1, Dulce M Barrios2, Gregory S Phillips2

  • 1Weill Cornell Medicine, New York, New York; Memorial Sloan Kettering Cancer Center, New York, New York.

Journal of the American Academy of Dermatology
|March 21, 2021
PubMed
Abstract

Insights

Patients on active checkpoint inhibitor (CPI) therapy have a higher risk of dermatologic infections. Anti-cytotoxic T-lymphocyte-associated antigen-4 monotherapy poses the greatest risk, necessitating increased vigilance for infections in these patients.

Area of Science:

  • Oncology
  • Dermatology
  • Immunology

Background:

  • Systematic description of dermatologic infections in patients receiving checkpoint inhibitors (CPIs) is lacking.
  • Checkpoint inhibitors are increasingly used in cancer treatment, potentially altering skin health.

Purpose of the Study:

  • To determine the incidence of dermatologic infections in patients undergoing treatment with CPIs.
  • To identify specific types of infections and risk factors associated with CPI use.

Main Methods:

  • Retrospective review of dermatologic infections in patients treated with CPIs between 2005 and 2020.
  • Analysis of data from patients evaluated by dermatologists at Memorial Sloan Kettering Cancer Center.

Main Results:

  • The dermatologic infection rate was significantly higher in patients actively receiving CPIs (17.5%) compared to those not actively treated (8.2%).
  • Bacterial infections were most common (36.2%), followed by fungal (34.5%) and viral (21.2%).
  • Anti-cytotoxic T-lymphocyte-associated antigen-4 monotherapy was linked to the highest infection risk (HR, 2.93).

Conclusions:

  • Patients actively on CPIs exhibit increased susceptibility to dermatologic infections.
  • Anti-cytotoxic T-lymphocyte-associated antigen-4 monotherapy is associated with the highest risk, warranting heightened clinical suspicion for infections.
  • Increased vigilance and prompt management of infections are crucial to minimize morbidity in CPI-treated patients.
Keywords:
anti-CTLA-4anti-PD-1anti-PD-L1cancercheckpoint inhibitorsdermatologic infections

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