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Treatment outcomes of immune-related cutaneous adverse events

Journal of Clinical Oncology Oct 18, 2019

Phillips GS, Wu J, Hellmann MD, et al. - Researchers aimed to assess if, in an uncontrolled cohort of patients referred to oncodermatology clinics, topical and systemic treatments are efficacious for immune-related cutaneous adverse events (ircAEs) attributed to checkpoint inhibitors. They performed a retrospective analysis of 285 patients (median age, 65 years [range, 17 to 89 years]) with 427 ircAEs: pruritus (n = 138; 32%), maculopapular rash (n = 120; 28%), psoriasiform rash (n = 22; 5%), and others (n = 147; 34%). They associated immune checkpoint inhibitor class with ircAE phenotype, where predominance of maculopapular rash was observed in patients who received combination therapy. Dermatologic interventions, including topical corticosteroids, oral antipruritics, and systemic immunomodulators, led to a significant reduction in severity of ircAEs was noted (mean Common Terminology Criteria for Adverse Events grade: 1.74 v 0.71). Findings thus indicate the efficacy of symptom- and phenotype-directed dermatologic therapies in most ircAEs, whereas patients with corticosteroid-refractory disease responded to biologic therapies. ircAEs seemed to be correlated with increased eosinophils, IL-6, IL-10, and immunoglobulin E, which may represent actionable therapeutic targets for immune-related skin toxicities.
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