Targeted therapies induced depigmentation: a review

Area of Science:

• Integrates oncology, dermatology, and immunology to study cutaneous adverse events.
• Focuses on targeted therapies, including immune checkpoint inhibitors, BRAF, and tyrosine kinase inhibitors.

Background:

• Vitiligo-like depigmentation (VLD) is a frequent cutaneous adverse event in patients receiving targeted therapies for cancer and autoimmune diseases.
• VLD can cause significant psychological distress and impact treatment adherence, despite sometimes being a marker of favorable prognosis.
• The immunopathologic mechanisms underlying VLD induced by various targeted agents remain incompletely understood.

Purpose of the Study:

• To explore the immunopathologic mechanisms of VLD induced by targeted therapies (cancer, autoimmune diseases, vaccines).
• To examine clinical presentations, prognostic implications, and management strategies for VLD.
• To highlight the correlation between VLD and improved therapeutic outcomes, and the challenges in balancing efficacy with quality of life.

Main Methods:

• Comprehensive literature review integrating findings from oncology, dermatology, and immunology.
• Analysis of VLD cases associated with immune checkpoint inhibitors, BRAF inhibitors, tyrosine kinase inhibitors, vaccines, and biologics.
• Examination of clinical data, prognostic significance, and therapeutic management approaches.

Main Results:

• VLD is a prevalent adverse event linked to targeted therapies, often associated with positive treatment responses.
• Specific targeted agents, including immune checkpoint inhibitors, are implicated in VLD development.
• VLD presents challenges in patient quality of life management despite its prognostic value.

Conclusions:

• Understanding the immunopathologic basis of VLD is crucial for optimizing targeted therapy outcomes.
• Multidisciplinary approaches involving oncology, dermatology, and immunology are needed for effective VLD management.
• Further research is required to enhance the prevention and treatment strategies for VLD in diverse clinical settings.