To treat or not to treat: PD-L1 inhibitor-induced keratoacanthoma and squamous cell carcinoma

Poole, Mackenzie; Schwartz, Robert A.; Lambert, W. Clark; Alhatem, Albert

doi:10.1007/s00403-022-02468-3

Cited by 5 publications

(9 citation statements)

References 38 publications

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“…7 KA remains an exceptionally rare cutaneous adverse effect of ICI therapy, with 22 reported cases of KA resulting from PD-1/PD-L1 inhibitor use. 5 Among these previously reported cases, median time from initiation of ICI therapy to KA diagnosis is 6 months, with a range from 1 to 18 months. Similar to spontaneous KA, ICI-induced KAs are more likely to occur in photodistributed areas and are more common in an elderly population with a median reported age of 75.5 years.…”

Section: Discussionmentioning

confidence: 98%

“…Similar to spontaneous KA, ICI-induced KAs are more likely to occur in photodistributed areas and are more common in an elderly population with a median reported age of 75.5 years. 5 Most cases of drug-induced eruptive KAs resolve spontaneously without discontinuation of the offending agent, although it is unclear if this occurs with ICI-induced KAs. 5 There is not a clear treatment guideline for ICI-induced KA, but most patients who develop eruptive KAs are treated successfully with topical and intralesional corticosteroids, excision, or cryotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…KA remains an exceptionally rare cutaneous adverse effect of ICI therapy, with 22 reported cases of KA resulting from PD-1/PD-L1 inhibitor use 5 . Among these previously reported cases, median time from initiation of ICI therapy to KA diagnosis is 6 months, with a range from 1 to 18 months.…”

Section: Discussionmentioning

confidence: 99%

“…Although KAs are a frequently encountered cutaneous tumor, they have rarely been reported to occur in the setting of ICI use. To date, 22 cases of ICI-induced KA have been reported in the literature 5 . Herein, we report a patient who developed multiple eruptive KAs 1 month after initiating treatment with nivolumab, a PD-1 inhibitor, for recurrent metastatic oropharyngeal SCC.…”

mentioning

confidence: 98%

“…To date, 22 cases of ICI-induced KA have been reported in the literature. 5 Herein, we report a patient who developed multiple eruptive KAs 1 month after initiating treatment with nivolumab, a PD-1 inhibitor, for recurrent metastatic oropharyngeal SCC.…”

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confidence: 99%

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Multiple Eruptive Keratoacanthomas Secondary to Nivolumab Immunotherapy

Olsen,

Svoboda,

Montanez-Wiscovich

et al. 2023

Journal of Immunotherapy

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Immune checkpoint inhibitors are increasingly being utilized for the treatment of advanced neoplastic disease and have been associated with wide-ranging cutaneous adverse effects. Though exceedingly rare, eruptive keratoacanthomas have been associated with the use of immune checkpoint inhibitors such as pembrolizumab and nivolumab, whose molecular target is the programmed cell death protein 1. Herein, we detail a case of numerous eruptive keratoacanthomas arising in a patient one month after initiation of nivolumab for recurrent metastatic oropharyngeal squamous cell carcinoma. Treatment with multiple rounds of intralesional corticosteroids and a several-month course of oral acitretin resulted in partial improvement. Subsequent treatment with intralesional 5-fluorouracil demonstrated near-complete resolution of the keratoacanthomas without discontinuation of nivolumab. Although eruptive keratoacanthomas secondary to immune checkpoint inhibitors are exceptionally rare, physicians should be aware of this cutaneous adverse effect as their use becomes more widespread.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 98%

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confidence: 99%

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