Adverse Cutaneous Outbreaks by programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1) immune checkpoint inhibitors: A Review.

Abstract

The therapeutic use of humanized monoclonal anti-programmed cell death 1 (PD-1) (pembrolizumab, and nivolumab) and anti-programmed cell death ligand1 (PD-L1) (atezolizumab, avelumab, durvalumab) as potent anticancer therapies is rapidly increasing. The mechanism of signaling of anti-PD-1/PD-L1 involves triggering cytotoxic CD4+/CD8+T cell activation, which induces specific immunologic adverse events. The anti-PD-1/PD-L1 drugs can cause numerous cases of cutaneous reactions, hence these toxicities are characterized as the most frequent immune-related adverse events (irAEs). The majority of cutaneous irAEs triggered by immune checkpoint inhibitors range from nonspecific eruptions to detectible skin manifestations, which may be self-limiting and present an acceptable skin toxicity profile, while some may produce mild to life-threatening complications. This review aims to illuminate the associated cutaneous adverse events related to the drugs used in oncology along with the relevant mechanism(s). With this review article, an overview of the various adverse cutaneous manifestations of anti-PD-1 (pembrolizumab, and nivolumab) and anti-PD-L1 (atezolizumab, avelumab, durvalumab) therapy, as well as suggestions, have been provided, so that their recognition at early stages could help in better management and would prevent treatment discontinuation.