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Cutaneous Toxicities in the Setting of Immune Checkpoint Blockade:: The Era of Oncodermatopathology

Jonathan L Curry1, Susan Y Chon2, Mario L Marques-Piubelli3

  • 1Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

Surgical Pathology Clinics
|May 23, 2021
PubMed

Insights

Immune checkpoint inhibitor (ICI) therapy can cause skin reactions, known as cutaneous immune-related adverse events (irAEs). Understanding these irAEs helps classify them by histopathologic patterns, aiding oncodermatopathology.

Area of Science:

  • Oncodermatopathology
  • Immunodermatology
  • Cancer Therapeutics

Background:

  • Monoclonal immune checkpoint antibody blockade (ICI therapy) has transformed cancer treatment across medical specialties.
  • Cutaneous immune-related adverse events (irAEs) are common, unintended side effects of ICI therapy.
  • These irAEs necessitate specialized knowledge in oncodermatopathology.

Purpose of the Study:

  • To classify diverse morphologic types of cutaneous irAEs.
  • To categorize irAEs based on major histopathologic reaction patterns.
  • To compare immune mechanisms of ICI-related irAEs with their non-ICI counterparts.

Main Methods:

  • Histopathologic analysis of cutaneous irAEs.
  • Classification of irAEs by distinct morphologic and histopathologic patterns.
  • Comparative analysis of immune mechanisms in ICI-associated vs. non-associated conditions.

Main Results:

  • Cutaneous irAEs exhibit diverse morphologic presentations.
  • Classification into major histopathologic reaction patterns is feasible.
  • Preliminary findings indicate similarities and differences in immune mechanisms for lichenoid dermatitis, psoriasiform dermatitis, and bullous pemphigoid irAEs compared to non-ICI-associated conditions.

Conclusions:

  • Knowledge of cutaneous irAE morphology aids classification within oncodermatopathology.
  • Histopathologic reaction patterns are key to understanding ICI-induced skin toxicities.
  • Further research is needed to fully elucidate the distinct immune pathways involved in ICI-related irAEs.
Keywords:
Cutaneous toxicitiesImmune checkpoint inhibitorOncodermatopathology

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