Occurrences and Outcomes of Immune Checkpoint Inhibitors-Induced Vitiligo in Cancer Patients: A Retrospective Cohort Study

Babai, Samy; Voisin, Anne-Laure; Bertin, Célia; Gouverneur, Amandine; Le-Louët, Hervé

doi:10.1007/s40264-019-00875-6

Cited by 28 publications

(24 citation statements)

References 24 publications

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“…As expected, the immune checkpoint inhibitors pembrolizumab, nivolumab, and ipilimumab were significantly associated with the occurrence of vitiligo [7][8][9]16,17]. Accordingly, monoclonal antibody subclass was disproportionally associated with vitiligo and the increase in vitiligo reports observed after 2010 was also related to the development of these drugs.…”

Section: Discussionsupporting

confidence: 64%

Drug‐induced vitiligo: a case/non‐case study in Vigibase^®, the WHO pharmacovigilance database

Anthony

Bourneau‐Martin

Ghamrawi

et al. 2020

Fundamemntal Clinical Pharma

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Vitiligo is a common depigmenting disorder ensuing the loss of epidermal melanocytes. It is a multifactorial disease with immunological, genetic and environmental factors including drug exposure. The purpose of the study was to investigate the drugs and therapeutic subclasses associated with vitiligo occurrence reported in VigiBase®, the WHO pharmacovigilance database. A case/non‐case study was carried out by defining cases as vitiligo reports and non‐cases as all other reports. The reporting odds ratio (ROR) was calculated for the ‘suspected’ drugs and drug classes according to ATC level 4. During the study period, 741 cases of vitiligo were registered. Mean age was 49 ± 20 years. The disproportionality analysis showed an association between vitiligo and pembrolizumab (ROR 116.9, 95% Confidence Interval (CI) 94.8, 144.3), nivolumab (ROR 22.6, 95% CI 15.8, 32.4), ipilimumab (ROR 41.7, 95% CI 25.0, 69.7), imiquimod (ROR 152.8, 95% CI 103.0, 226.7), adalimumab (ROR 3.8, 95% CI 2.5,5.8), infliximab (ROR 2.6, 95% CI 1.65, 4.01), alemtuzumab (ROR 27.8, 95% CI 17.6, 43.9), and ustekinumab (ROR 9.3, 95% CI 5.6, 15.6). Concerning the pharmacological classes ATC level 4, a significant association was found with monoclonal antibodies, interferons, selective immunosuppressants, TNF‐alpha inhibitors, interleukin inhibitors, and topical antivirals. This study confirmed the expected associations between vitiligo and immune checkpoint inhibitors and strengthened the emerging signal about the association between vitiligo and imiquimod, TNF‐alpha inhibitors and interferons. New signals were shown with selective immunosuppressants including alemtuzumab and interleukin inhibitors.

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Section: Discussionsupporting

confidence: 64%

Drug‐induced vitiligo: a case/non‐case study in Vigibase^®, the WHO pharmacovigilance database

Anthony

Bourneau‐Martin

Ghamrawi

et al. 2020

Fundamemntal Clinical Pharma

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“…Incidence of IRAEs differs between different tumors types and can be correlated to treatment response. Development of vitiligo is much more frequent in melanoma patients than in patients with other solid tumors [14][15][16]. Melanoma patients with vitiligo have a better overall survival compared to patients without vitiligo [17].…”

Section: Introductionmentioning

confidence: 99%

Checkpoint inhibitor induced hepatitis and the relation with liver metastasis and outcome in advanced melanoma patients

et al. 2021

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Background Checkpoint inhibitor-induced hepatitis is an immune-related adverse event of programmed cell death protein 1 (PD-1) inhibition, cytotoxic T-lymphocyte associated 4 (CTLA-4) inhibition or the combination of both. Aim of this study was to assess whether checkpoint inhibitor-induced hepatitis is related to liver metastasis and outcome in a real-world nationwide cohort. Methods Data from the prospective nationwide Dutch Melanoma Treatment Registry (DMTR) was used to analyze incidence, risk factors of checkpoint inhibitor-induced grade 3–4 hepatitis and outcome. Results 2561 advanced cutaneous melanoma patients received 3111 treatments with checkpoint inhibitors between May 2012 and January 2019. Severe hepatitis occurred in 30/1620 (1.8%) patients treated with PD-1 inhibitors, in 29/1105 (2.6%) patients treated with ipilimumab and in 80/386 (20.7%) patients treated with combination therapy. Patients with hepatitis had a similar prevalence of liver metastasis compared to patients without hepatitis (32% vs. 27%; p = 0.58 for PD-1 inhibitors; 42% vs. 29%; p = 0.16 for ipilimumab; 38% vs. 43%; p = 0.50 for combination therapy). There was no difference in median progression free and overall survival between patients with and without hepatitis (6.0 months vs. 5.4 months progression-free survival; p = 0.61; 17.0 vs. 16.2 months overall survival; p = 0.44). Conclusion Incidence of hepatitis in a real-world cohort is 1.8% for PD-1 inhibitor, 2.6% for ipilimumab and 20.7% for combination therapy. Checkpoint inhibitor-induced hepatitis had no relation with liver metastasis and had no negative effect on the outcome.

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“…Babai et al [ 16 ] have reported depigmentation affecting predominantly photo-exposed body areas such as the face and the hands in 46% of cases of vitiligo induced by ICIs.…”

Section: Vitiligomentioning

confidence: 99%

“…A recent study reported the repigmentation after the cessation of immunotherapy in six patients, which the authors suggest to be associated with melanoma progression [ 16 ].…”

Section: Vitiligomentioning

confidence: 99%

Cutaneous Events Associated with Immunotherapy of Melanoma: A Review

Burzi

Alessandrini

Quaglino

et al. 2021

JCM

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Occurrences and Outcomes of Immune Checkpoint Inhibitors-Induced Vitiligo in Cancer Patients: A Retrospective Cohort Study

Cited by 28 publications

References 24 publications

Drug‐induced vitiligo: a case/non‐case study in Vigibase^®, the WHO pharmacovigilance database

Drug‐induced vitiligo: a case/non‐case study in Vigibase^®, the WHO pharmacovigilance database

Checkpoint inhibitor induced hepatitis and the relation with liver metastasis and outcome in advanced melanoma patients

Cutaneous Events Associated with Immunotherapy of Melanoma: A Review

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Occurrences and Outcomes of Immune Checkpoint Inhibitors-Induced Vitiligo in Cancer Patients: A Retrospective Cohort Study

Cited by 28 publications

References 24 publications

Drug‐induced vitiligo: a case/non‐case study in Vigibase®, the WHO pharmacovigilance database

Drug‐induced vitiligo: a case/non‐case study in Vigibase®, the WHO pharmacovigilance database

Checkpoint inhibitor induced hepatitis and the relation with liver metastasis and outcome in advanced melanoma patients

Cutaneous Events Associated with Immunotherapy of Melanoma: A Review

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Product

Resources

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Drug‐induced vitiligo: a case/non‐case study in Vigibase^®, the WHO pharmacovigilance database

Drug‐induced vitiligo: a case/non‐case study in Vigibase^®, the WHO pharmacovigilance database