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Assessment of Chimeric Antigen Receptor T Cell-Associated Toxicities Using an Acute Lymphoblastic Leukemia Patient-Derived Xenograft Mouse Model

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Side Effects of Cancer Immunotherapies: Dermatologic and Rheumatologic Toxicities.

Daniele Frisone¹, Pierre O Chappuis^2,3

¹Service d'oncologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland.

|March 1, 2023

Summary

Immune checkpoint inhibitors can cause severe skin and joint toxicities in cancer patients. Early recognition and management, including corticosteroids for skin issues, are crucial for patient outcomes.

Keywords:

Immuncheckpoint-Inhibitoren Immuntherapie Rheumatologic toxicity Rheumatologische Toxizität Toxicité rhumatologique dermatologic toxicity dermatologische Toxizität immune checkpoint inhibitors immunotherapy immunothérapie inhibiteurs de points de contrôle immunitaire toxicité dermatologique

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Published on: March 7, 2025

Area of Science:

Oncology
Dermatology
Rheumatology

Background:

Immune checkpoint inhibitors (ICIs) are widely used in oncology but frequently cause immune-related adverse events (irAEs).
Dermatologic and rheumatologic toxicities are common irAEs that require prompt recognition and management.
These toxicities can range from mild to life-threatening, impacting patient treatment and outcomes.

Purpose of the Study:

To highlight the importance of timely identification and referral for dermatologic and rheumatologic toxicities associated with ICI therapy.
To provide guidance on the diagnosis and management of specific cutaneous toxicities.
To underscore the heterogeneity and potential severity of rheumatologic toxicities.

Main Methods:

Review of clinical presentation and management strategies for ICI-induced dermatologic toxicities, including maculopapular rash and bullous dermatitis.
Discussion of the characteristics and diagnostic considerations for ICI-induced rheumatologic toxicities, noting their potential absence of autoantibodies.
Emphasis on clinical assessment based on affected body surface area for skin lesions and recognition of heterogeneous rheumatologic manifestations.

Main Results:

Cutaneous toxicities require diagnosis and management based on the extent of skin lesions.
Corticosteroids are a primary treatment for moderate to severe skin toxicities.
Rheumatologic toxicities are less common, more varied, and can be severe, even life-threatening, sometimes occurring without autoantibodies.

Conclusions:

Effective management of ICI-related dermatologic and rheumatologic toxicities is essential for patient safety and treatment continuity.
Clinical vigilance and appropriate referral are critical for addressing these potentially severe adverse events.
Understanding the specific manifestations and management principles for both skin and joint toxicities improves patient care during ICI therapy.