Principles of prophylactic and therapeutic management of skin toxicity during treatment with checkpoint inhibitors

Grażyna Kamińska-Winciorek; Bożena Cybulska-Stopa; Iwona Ługowska; Marek Ziobro; Piotr Rutkowski

doi:10.5114/ada.2018.80272

eISSN: 2299-0046
ISSN: 1642-395X

Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii

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abstract:

Review paper

Principles of prophylactic and therapeutic management of skin toxicity during treatment with checkpoint inhibitors

Grażyna Kamińska-Winciorek

¹

,

Bożena Cybulska-Stopa

²

,

Iwona Ługowska

^{3, 4, 5}

,

Marek Ziobro

²

,

Piotr Rutkowski

³

Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sk³odowska-Curie Institute – Oncology Center, Gliwice Branch, Gliwice, Poland
Maria Sk³odowska-Curie Institute – Oncology Center, Krakow Branch, Krakow, Poland
Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sk³odowska-Curie Institute – Oncology Center, Warsaw, Poland
Department of Epidemiology and Biostatistics, Mother and Child Institute, Warsaw, Poland
Early Phase Clinical Trials Unit, Warsaw, Maria Sk³odowska-Curie Institute – Oncology Center, Warsaw, Poland

Adv Dermatol Allergol 2019; XXXVI (4): 382-391

DOI: https://doi.org/10.5114/ada.2018.80272

Online publish date: 2019/08/30

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AMA

Kamińska-Winciorek G, Cybulska-Stopa B, Ługowska I, Ziobro M, Rutkowski P. Principles of prophylactic and therapeutic management of skin toxicity during treatment with checkpoint inhibitors. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2019;36(4):382-391. doi:10.5114/ada.2018.80272.

APA

Kamińska-Winciorek, G., Cybulska-Stopa, B., Ługowska, I., Ziobro, M.,  & Rutkowski, P. (2019). Principles of prophylactic and therapeutic management of skin toxicity during treatment with checkpoint inhibitors. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 36(4), 382-391. https://doi.org/10.5114/ada.2018.80272

Chicago

Kamińska-Winciorek, Grażyna, Bożena Cybulska-Stopa, Iwona Ługowska, Marek Ziobro,  and Piotr Rutkowski. 2019. "Principles of prophylactic and therapeutic management of skin toxicity during treatment with checkpoint inhibitors". Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii 36 (4): 382-391. doi:10.5114/ada.2018.80272.

Harvard

Kamińska-Winciorek, G., Cybulska-Stopa, B., Ługowska, I., Ziobro, M.,  and Rutkowski, P. (2019). Principles of prophylactic and therapeutic management of skin toxicity during treatment with checkpoint inhibitors. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 36(4), pp.382-391. https://doi.org/10.5114/ada.2018.80272

MLA

Kamińska-Winciorek, Grażyna et al. "Principles of prophylactic and therapeutic management of skin toxicity during treatment with checkpoint inhibitors." Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, vol. 36, no. 4, 2019, pp. 382-391. doi:10.5114/ada.2018.80272.

Vancouver

Kamińska-Winciorek G, Cybulska-Stopa B, Ługowska I, Ziobro M, Rutkowski P. Principles of prophylactic and therapeutic management of skin toxicity during treatment with checkpoint inhibitors. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2019;36(4):382-391. doi:10.5114/ada.2018.80272.

The introduction of immunotherapy into the treatment of cancer patients has revolutionised the oncological approach and significantly improved patient survival. The key drugs are immune checkpoint inhibitors (CPIs), whose mechanism of action is to elicit immune response against cancer cell antigens. Three types of CPIs are currently used and approved: an anti-CTLA-4 antibody, ipilimumab; anti-PD-1 antibodies, nivolumab and pembrolizumab; and anti-PD-L1 antibodies: atezolizumab, avelumab and durvalumab. CPIs have been widely used in metastatic and adjuvant melanoma settings, metastatic lung cancer, Hodgkin’s lymphoma, renal cancer, bladder cancer, head and neck tumours, and Merkel cell carcinoma. However, side effects of CPIs differ from toxicities of other oncological drugs. According to literature data, in 10–30% of patients CPIs are responsible for immune-related adverse events (irAE) associated with excessive activation of the immune system. Systemic irAEs include enterocolitis, pneumonitis, hepatitis, nephritis, hypophysitis, and autoimmune thyroid disease. However, the most common irAEs of checkpoint inhibitors are dermatologic toxicities ranging from pruritus and mild dermatoses to severe reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis. Each irAE can become serious if not early diagnosed and appropriately treated. In the article we present different types of skin irAEs related to CPIs together with the recommended therapies.

keywords:

Principles of prophylactic and therapeutic management of skin toxicity during treatment with checkpoint inhibitors

Grażyna Kamińska-Winciorek 1 , Bożena Cybulska-Stopa 2 , Iwona Ługowska 3, 4, 5 , Marek Ziobro 2 , Piotr Rutkowski 3

skin toxicities, immune checkpoint antibody

Grażyna Kamińska-Winciorek

¹

,

Bożena Cybulska-Stopa

²

,

Iwona Ługowska

^{3, 4, 5}

,

Marek Ziobro

²

,

Piotr Rutkowski

³