Vitiligo-Like Depigmentation in Patients With Stage III-IV Melanoma Receiving Immunotherapy and Its Association With Survival: A Systematic Review and Meta-Analysis

Teulings, Hansje Eva; Limpens, Jacqueline; Jansen, Sophia N.; Zwinderman, Aeilko H.; Reitsma, Johannes B.; Spuls, Phyllis I.; Luiten, Rosalie M.

doi:10.1200/jco.2014.57.4756

Cited by 538 publications

(416 citation statements)

References 136 publications

Supporting

Mentioning

379

Contrasting

Unclassified

Order By: Relevance

“…4,5,7,8 An association between appearance of skin irAEs and OS in melanoma has been reported. [13][14][15]17 Similarly, our data suggest an association between skin irAEs and tumor response. The histological analysis of the rashes on the one hand allowed us to rule out clinical differential diagnoses of eczema and psoriasis and on the other hand revealed that the rashes were characterized by an inflammation rich in CD3C T-lymphocytes.…”

Section: Discussionmentioning

confidence: 48%

Characterization of nivolumab-associated skin reactions in patients with metastatic non-small cell lung cancer

et al. 2016

View full text Add to dashboard Cite

Immune checkpoint inhibitors have led to considerable therapy improvement in cancer patients. Autoimmune side effects including skin reactions are frequently observed. In melanoma, those include rash and vitiligo and were shown to be associated with a prolonged overall survival. Little is known about skin reactions in non-small cell lung cancer (NSCLC) patients during immunotherapy. Here, we retrospectively investigated immune-related adverse skin reactions (irAEs) in 40 patients with metastatic NSCLC treated with the anti-PD-1 antibody nivolumab. 7 out of 40 patients (17%) developed an irAEs. Skin irAEs correlated with tumor responses in 5 of 12 responders (42%) as compared to 2 of 27 non-responders (7%). Histologically, scaly plaques showed dermatitis consisting mainly of lymphocytes. We observed a positive correlation between skin irAEs and tumor responses in patients with NSCLC treated with nivolumab. Patterns of lymphocytic skin infiltration differed depending on the histological tumor subtype (adenocarcinoma versus squamous cell carcinoma NSCLC).

show abstract

Section: Discussionmentioning

confidence: 48%

Characterization of nivolumab-associated skin reactions in patients with metastatic non-small cell lung cancer

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Biomarker studies of tumor biopsies have identified tumor and immune markers predictive of beneficial anti-tumor responses to checkpoint therapy 68 , including PD-L1 expression on tumor cells and CD8 + T cell infiltration of the TME. The occurrence of autoimmune skin depigmentation (vitiligo) after immunotherapy with a variety of modalities is associated with improved long-term survival 69 . In addition, the typical kinetics of the onset of immunotoxicity have been described for some therapies, including ipilimumab, in which skin conditions are typically seen as the first manifestation, followed by colitis, and later, hepatitis and polyendocrinopathies 70 .…”

Section: Autoimmune Consequencesmentioning

confidence: 99%

Is autoimmunity the Achilles' heel of cancer immunotherapy?

June

Warshauer

Bluestone

2017

Nat Med

388

308

View full text Add to dashboard Cite

“…However, symptoms on an average start 3-4 weeks after treatment. Vitiligo has also been reported [19,20] (Figure 2). In severe cases, toxic epidermal necrolysis and Stevens-Johnson syndrome can occur, but in less than 1% of patients [15,19].…”

Section: Dermatologicalmentioning

confidence: 92%

“…Vitiligo may be associated with clinical beneit. Although it occurs in a small percentage of patients undergoing immunotherapy, there is a clear survival beneit in patients who do develop vitiligo during treatment [19,20]. In some patients, vitiligo is associated with long-term survival [19,20].…”

Section: Managementmentioning

confidence: 99%

Management and Supportive Care of Patients Undergoing Immunotherapy

Rapoport¹,

Eeden²

2017

Immunotherapy - Myths, Reality, Ideas, Future

View full text Add to dashboard Cite

In many tumor types, where the prognosis was shown to be extremely dismal before, immunotherapy is now a new beacon of hope to many patients. Immunotherapy has been approved for use in a many diferent cancers including metastatic melanoma, advanced non-small cell lung cancer, metastatic renal cell carcinoma, refractory Hodgkin's lymphoma, metastatic bladder cancer advanced head and neck cancer, and the list keeps growing each day. It seems to be generally beter tolerated in most patients and less toxic compared to what we have seen in diferent anticancer treatments from before. However, the toxicities here are termed immune-related adverse events. There is almost no prospective data on these toxicities, and guidelines or recommendations are mostly based on symptomatic management from the ongoing clinical trials. Treating oncologists need to be aware of the subtleties in presentation and the huge diference in the way we mange these side efects. Although most adverse events are low-grade and manageable, they have the potential to be life-threatening if not treated promptly. In this chapter, we address the diferent immune-related adverse events relating to the organ system they can involve, presentation and symptomatology, general recommendations of management, and individual toxicities. Keywords: immunotherapy, PD-1, CTLA-4.

show abstract

Vitiligo-Like Depigmentation in Patients With Stage III-IV Melanoma Receiving Immunotherapy and Its Association With Survival: A Systematic Review and Meta-Analysis

Cited by 538 publications

References 136 publications

Characterization of nivolumab-associated skin reactions in patients with metastatic non-small cell lung cancer

Characterization of nivolumab-associated skin reactions in patients with metastatic non-small cell lung cancer

Is autoimmunity the Achilles' heel of cancer immunotherapy?

Management and Supportive Care of Patients Undergoing Immunotherapy

Contact Info

Product

Resources

About