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Updated: Sep 20, 2025

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Characterization of Cutaneous Adverse Events Associated With PI3K Inhibitors in 11 Patients

Padmavathi V Karri1,2, Benjamin D Freemyer1,2, Omar Pacha1

  • 1Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Journal of Immunotherapy and Precision Oncology
|June 6, 2022
PubMed
Abstract

Insights

Phosphoinositide 3-kinase (PI3K) inhibitors can cause severe skin reactions. Most cutaneous adverse events (CAEs) were manageable with standard treatments, but some required dose adjustments, underscoring the need for dermatological management.

Area of Science:

  • Oncology
  • Dermatology
  • Pharmacology

Background:

  • Phosphoinositide 3-kinase (PI3K) inhibitors target the PI3K/AKT/mTOR pathway for cancer treatment.
  • These inhibitors are associated with a higher incidence of cutaneous adverse events (CAEs) compared to other tyrosine kinase inhibitors.
  • Characterization and management strategies for PI3K inhibitor-induced CAEs are lacking.

Purpose of the Study:

  • To characterize the clinical presentation and outcomes of cutaneous adverse events (CAEs) in patients treated with phosphoinositide 3-kinase (PI3K) inhibitors.
  • To evaluate the management strategies and impact of CAEs on cancer therapy.

Main Methods:

  • Retrospective chart review of patients receiving PI3K inhibitors between January 2015 and May 2019.
  • Electronic medical records were queried using pharmacy databases and ICD-10 codes for patients experiencing CAEs.
  • CAEs were characterized by two board-certified dermatologists.

Main Results:

  • Eleven patients experienced 12 cumulative CAEs, with an average onset of 4 weeks.
  • The most common rashes were eczematous (25%) and morbilliform (17%).
  • Four patients required dose delays, and one discontinued therapy due to CAEs.

Conclusions:

  • Most PI3K inhibitor-related CAEs were mild (grade 1-2) and responsive to topical corticosteroids and oral antihistamines.
  • Despite manageable toxicity, some CAEs necessitated dose adjustments, impacting treatment continuity.
  • Dermatological intervention is crucial for managing CAEs, minimizing therapy interruption, and preserving patient quality of life.
Keywords:
PI3Kadverse drug reactiondermato-oncologydrug eruption

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