Management of immune checkpoint inhibitor‐related dermatologic adverse events

Si, Xiaoyan; He, Chun‐Xia; Liu, Xiaowei; Li, Yue; Wang, Hanping; Guo, Xiaoxiao; Zhou, Jiaxin; Duan, Lian; Wang, Mengzhao; Zhang, Li

doi:10.1111/1759-7714.13275

Cited by 21 publications

(14 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dermatologic toxicities are among the most common immune-related adverse events encountered in daily practice when treating lung cancer with an estimated incidence of 44% following CTLA-4 inhibition and 34% with PD-1/PD-L1 targeting treatment ( 23 ). Early data have previously suggested that similarity between tumor antigen and somatic epitopes within the skin and fascia may provide a mechanistic explanation for the occurrence of dermatologic events ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Management of Immune-Related Adverse Events in Patients With Non-Small Cell Lung Cancer

Burke

Rashdan

2021

Front. Oncol.

View full text Add to dashboard Cite

With proven efficacy of the use of immunotherapy in almost all stages of NSCLC, immunotherapy toxicity has become a very important topic that requires immediate recognition and management. The diagnosis of toxicities associated with immunotherapy in lung cancer can be very challenging and often requires multidisciplinary effort. This mini review gives an overview of the diagnosis and management of immune-related adverse events that arise from using immunotherapy in NSCLC, as well as the potential biomarkers for its early identification and future directions.

show abstract

Section: Discussionmentioning

confidence: 99%

Management of Immune-Related Adverse Events in Patients With Non-Small Cell Lung Cancer

Burke

Rashdan

2021

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…The SJS was assessed to be grade 3 by CTCAE v5.0. The literature recommends complete cessation of the inducing drug, and immunoglobulin or corticosteroid is recommended to treat SJS along with supportive and symptomatic management (13)(14)(15). Although there was a possibility that SJS could be related to the enzalutamide dose, enzalutamide was discontinued immediately, considering SJS is a serious skin reaction and the patient's age.…”

Section: Discussionmentioning

confidence: 99%

Stevens-Johnson Syndrome Caused by Enzalutamide: A Case Report and Literature Review

et al. 2021

View full text Add to dashboard Cite

ObjectiveEnzalutamide is the most frequently prescribed compound for treating metastatic castration-resistant prostate cancer (mCRPC). Common adverse drug events of enzalutamide are febrile neutropenia, hot flashes, hypertension, and fatigue.MethodsWe present a case of a patient with mCRPC who received enzalutamide and developed Stevens-Johnson syndrome (SJS). The culprit drug was confirmed using the Naranjo Adverse Drug Reaction Probability Scale. Clinical characteristics and management principles were analyzed in combination with literature reports.ResultsSJS occurred within two weeks of enzalutamide therapy. Supportive care such as steroid treatment led to a complete resolution of skin lesions and improved clinical symptoms after three weeks.ConclusionMost cutaneous adverse events occur early during enzalutamide therapy, and close observation should be given within two weeks of starting treatment.

show abstract

“…It has been previously proposed that immunotherapies emerge as a trigger for SCARs, as immune checkpoint inhibition may predispose patients to skin hypersensitivity 32,53–55 . Thus, in addition to drug discontinuation and supportive care, these denominated immune‐related SCAR‐like reactions, may be treated mainly with corticosteroids 56,57 , 58–60 . Conversely, no high evidence‐level guidelines exist for targeted therapies‐induced SCARs; therefore, they may be managed in the same directions as regular SCARs.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of BRAF/MEK inhibitors‐induced Severe Cutaneous Adverse Reactions (SCARs)

Torres‐Navarro

Unamuno‐Bustos

Botella‐Estrada

2020

Acad Dermatol Venereol

View full text Add to dashboard Cite

Severe cutaneous adverse reactions (SCARs) [Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug rash with eosinophilia and systemic syndrome (DRESS), acute generalized exanthematous pustulosis (AGEP), and generalized bullous fixed eruption (GBFE)] are severe drug reactions that often require hospitalization and could be fatal. BRAF and MEK inhibitors (BRAF/MEKi) are a standard of care in patients with BRAF‐mutated metastatic melanomas. These agents are administered until disease progression or unacceptable toxicity occurs. This review has focus on BRAF/MEKi‐induced SCARs. A systematic search of the following terms: ‘vemurafenib’, ‘cobimetinib’, ‘dabrafenib’, ‘trametinib’, ‘encorafenib’, ‘binimetinib’, ‘Acute Generalized Exanthematous Pustulosis’, ‘Stevens Johnson syndrome’, ‘Toxic Epidermal Necrolysis’, ‘Generalized Bullous Fixed Eruption’ ‘Drug Hypersensitivity Syndrome’, and ‘DRESS’ in simple combination (every drug with each disease) and all in combination, was performed on MEDLINE, EMBASE, Web of Knowledge and The Cochrane Library repositories, with no restriction on language, for original studies. One hundred sixty‐eight original articles were found, 26 (retrospective series, case reports and conference abstracts) were selected, and 21 were included in the qualitative synthesis. A total of 31 SCAR cases (23 DRESS and 8 SJS/TEN – 1 SJS and 7 TEN –) were identified. Vemurafenib was the culprit drug in all but one case, which was dabrafenib‐induced. Mean time to SCAR onset from drug intake was 15.5 and 11.4 days, for SJS/TEN and DRESS, respectively. For the DRESS cases, hepatic involvement occurred in 96% and renal alterations in 87% of patients. Overall, BRAF/MEKi‐induced SCARs are rare. Among them, vemurafenib is the drug that requires more close monitoring for SCARs. Prior immunotherapy can favour SCARs. Vemurafenib DRESS is likely to occur within the first fifteen days of treatment accompanied by hepatic and renal involvement. Following vemurafenib‐induced SCAR resolution, switching to dabrafenib seems to be a safe alternative for these patients’ treatment.

show abstract

Management of immune checkpoint inhibitor‐related dermatologic adverse events

Cited by 21 publications

References 25 publications

Management of Immune-Related Adverse Events in Patients With Non-Small Cell Lung Cancer

Management of Immune-Related Adverse Events in Patients With Non-Small Cell Lung Cancer

Stevens-Johnson Syndrome Caused by Enzalutamide: A Case Report and Literature Review

Systematic review of BRAF/MEK inhibitors‐induced Severe Cutaneous Adverse Reactions (SCARs)

Contact Info

Product

Resources

About