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Cutaneous adverse events in lung cancer patients on the therapy based on PD-1/PD-L1 inhibitors: A prospective
Yong-Chao Dang1, Qing-Tao Kong1, Zhen Wang2
1Department of Dermatology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China.
Aim:
This is a prospective study of cutaneous adverse events (CAEs) in lung cancer patients treated by programmed cell death-1(PD-1) inhibitors and programmed cell death-ligand 1(PD-L1) inhibitors-based single or combination therapy.
Patients & Methods:
It were included that lung cancer patients who developed CAEs from January 2019 to July 2021 after applying PD-1/PD-L1 inhibitors in our institution.
Results:
A total of 107 patients with 112 CAEs were enrolled, of which 71 patients received PD-1/PD-L1 inhibitors plus chemotherapy, 31 patients received PD-1/PD-L1 inhibitors plus anti-angiogenic/targeted therapy, and 5 patients received PD-1/PD-L1 inhibitors monotherapy. The median time to CAEs onset was 8.7w (0.3w-70.7w) for PD-1/PD-L1 inhibitors plus chemotherapy, 10.1w (0.4w-103.0w) for PD-1/PD-L1 inhibitors plus anti-angiogenic/targeted therapy, and 13.6w (0.7w-50.6w) for PD-1/PD-L1 inhibitors monotherapy. The most common CAEs were reactive cutaneous capillary endothelial proliferation (RCCEP) (30.8%, 33/107), followed by eczematous (21.5%, 23/107) and pruritus only (15.9%, 17/107). 7 patients (6.5%, 7/107) had grade 3-4 CAE.
Conclusion:
Most CAEs are mild to moderate and easily controlled. Early diagnosis and intervention for CAEs are important.
Insights
Cutaneous adverse events (CAEs) are common in lung cancer patients treated with programmed cell death-1 (PD-1) or programmed cell death-ligand 1 (PD-L1) inhibitors. Most CAEs are mild and manageable with early intervention.
Area of Science:
- Oncology
- Dermatology
- Immunotherapy
Background:
- Lung cancer treatment increasingly utilizes immune checkpoint inhibitors like PD-1 and PD-L1 inhibitors.
- Cutaneous adverse events (CAEs) are frequent side effects of these immunotherapies.
- Understanding the spectrum and management of CAEs is crucial for patient care.
Purpose of the Study:
- To prospectively investigate the incidence, types, and timing of CAEs in lung cancer patients receiving PD-1/PD-L1 inhibitor-based therapies.
- To characterize the severity and common presentations of CAEs in this patient population.
Main Methods:
- Prospective study of lung cancer patients treated with PD-1/PD-L1 inhibitors from January 2019 to July 2021.
- Data collection included patient demographics, treatment regimens, and detailed documentation of CAEs.
- Analysis of CAE types, onset time, and severity (Grade 3-4).
Main Results:
- 107 lung cancer patients experienced 112 CAEs during treatment with PD-1/PD-L1 inhibitors (monotherapy or combination).
- The most frequent CAEs were reactive cutaneous capillary endothelial proliferation (RCCEP), eczematous reactions, and pruritus.
- Median time to CAE onset varied by treatment, with combination therapies showing earlier onset.
- Only 6.5% of patients experienced severe (Grade 3-4) CAEs.
Conclusions:
- Cutaneous adverse events associated with PD-1/PD-L1 inhibitors in lung cancer are generally mild to moderate.
- Early diagnosis and prompt intervention are key for effective management of these events.
- These findings support the continued use of PD-1/PD-L1 inhibitors with appropriate dermatological monitoring.
