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SHR Neuro Cancer Cardio Lipid Metab Microb

L'Orphelin, JM; Cassecuel, J; Kandolf, L; Harwood, CA; Tookey, P; Junejo, MH; Hogan, S; Lebbe, C; Appalla, Z; Kranke, TM; Pellacani, G; Cerasuolo, D; Dujovic, B; Del Marmol, V; Forschner, A; Garbe, C; Bataille, V; Ressler, JM; Sollena, P; Dompmartin, A; Peris, K; Dreno, B.
Cutaneous manifestations induced by check point inhibitors in 120 melanoma patients-The European MelSkinTox study
J EUR ACAD DERMATOL. 2023; Doi: 10.1111/jdv.19112
Web of Science PubMed FullText FullText_MUG

Co-authors Med Uni Graz: Kränke Teresa Maria
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Abstract:: BackgroundCheckpoint inhibitors provide an effective approach for the melanoma treatment. They prolong lymphocyte effects, which explains the cytotoxicity underlying immune-related adverse events (IrAEs). Cutaneous IrAEs affect nearly 40% of PD-1i and 50% of CTLA4i-treated patients. Severe cutaneous irAE do not often occur but could be life-threatening and may persist despite treatment discontinuation. MethodsWe aimed to investigate cutaneous IrAEs in a cohort of patients treated with ICI across Europe in an effort to characterize the reactions in a real-world, phase IV, post-marketing study using a follow-up questionnaire.Data since November 2016 until March 2021 were obtained from the Melskintox database, a European multicentric biobank dedicated to the follow-up of melanoma and cutaneous adverse events, supported by EADO. The dermatoses reported were pooled into four categories: inflammatory dermatosis, bullous diseases, drug-related eruptions and pigmentary diseases. ResultsInflammatory benign dermatoses (n = 63) represented the most common group of reactions (52.5%), followed by drug-related eruptions (n = 24, 20%), pigmentary diseases (n = 23, 19.2%) and bullous diseases (n = 10, 8.3%). Grade II (n = 41, 34.2%) are represented by bullous pemphigoid, eczema, hypodermitis, lichenoid eruption, maculopapular rash, pruritus, psoriasis-like rash, urticarial eruption and vitiligo. Grade III (n = 18, 15.0%) are represented by bullous pemphigoid, lichenoid eruption and rashes. Grade IV (n = 2, 1.7%) is only represented by bullous disease. Most cutaneous IrAEs led to immunotherapy continuation (n = 95, 88.0%). CR is associated with more severe the cutaneous irAEs. We report an average time-to-onset of 208 days and some late-onset events. ConclusionOur study has characterized the clinical spectrum of cutaneous irAEs, their timing and severity and their relationship with tumour response. Grade I-II cutaneous IrAE are easily managed allowing ongoing anticancer treatment. Severe late-onset cutaneous irAE are not uncommon. A dermatological follow-up helps mitigate the risk of life-threatening adverse events. These findings highlight the importance of oncodermatological involvement in management of patients with melanoma receiving immunotherapy.