array:23 [
  "pii" => "S0001731023000534"
  "issn" => "00017310"
  "doi" => "10.1016/j.ad.2022.08.030"
  "estado" => "S300"
  "fechaPublicacion" => "2023-03-01"
  "aid" => "3364"
  "copyrightAnyo" => "2023"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2023;114:T288-T289"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0001731022007864"
    "issn" => "00017310"
    "doi" => "10.1016/j.ad.2022.08.019"
    "estado" => "S300"
    "fechaPublicacion" => "2023-03-01"
    "aid" => "3196"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2023;114:288-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENT&#205;FICO-CL&#205;NICA</span>"
      "titulo" => "Reacciones adversas dermatol&#243;gicas en pacientes con terapia dirigida contra inhibidores de la respuesta inmune"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "288"
          "paginaFinal" => "289"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Adverse Dermatologic Reactions in Patients Treated With Immune Checkpoint Inhibitors"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1273
              "Ancho" => 2508
              "Tamanyo" => 169958
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">N&#250;mero y distribuci&#243;n de manifestaciones dermatol&#243;gicas observadas en pacientes tratados con anti-PD1 y anti-PDL1&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "R&#46; Fayos Gregori, C&#46; Labrandero Hoyos, R&#46; Pe&#241;uelas Leal, V&#46; Alegre de Miquel"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Fayos Gregori"
            ]
            1 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Labrandero Hoyos"
            ]
            2 => array:2 [
              "nombre" => "R&#46; Pe&#241;uelas"
              "apellidos" => "Leal"
            ]
            3 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Alegre de Miquel"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022007864?idApp=UINPBA000044"
    "url" => "/00017310/0000011400000003/v1_202303051528/S0001731022007864/v1_202303051528/es/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:18 [
      "pii" => "S0001731022007864"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2022.08.019"
      "estado" => "S300"
      "fechaPublicacion" => "2023-03-01"
      "aid" => "3196"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2023;114:288-9"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENT&#205;FICO-CL&#205;NICA</span>"
        "titulo" => "Reacciones adversas dermatol&#243;gicas en pacientes con terapia dirigida contra inhibidores de la respuesta inmune"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "288"
            "paginaFinal" => "289"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Adverse Dermatologic Reactions in Patients Treated With Immune Checkpoint Inhibitors"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1273
                "Ancho" => 2508
                "Tamanyo" => 169958
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">N&#250;mero y distribuci&#243;n de manifestaciones dermatol&#243;gicas observadas en pacientes tratados con anti-PD1 y anti-PDL1&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "R&#46; Fayos Gregori, C&#46; Labrandero Hoyos, R&#46; Pe&#241;uelas Leal, V&#46; Alegre de Miquel"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Fayos Gregori"
              ]
              1 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Labrandero Hoyos"
              ]
              2 => array:2 [
                "nombre" => "R&#46; Pe&#241;uelas"
                "apellidos" => "Leal"
              ]
              3 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Alegre de Miquel"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022007864?idApp=UINPBA000044"
      "url" => "/00017310/0000011400000003/v1_202303051528/S0001731022007864/v1_202303051528/es/main.assets"
    ]
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>"
    "titulo" => " Adverse Dermatologic Reactions in Patients Treated With Immune Checkpoint Inhibitors"
    "tieneTextoCompleto" => true
    "saludo" => "To the Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "T288"
        "paginaFinal" => "T289"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "R&#46; Fayos Gregori, C&#46; Labrandero Hoyos, R&#46; Pe&#241;uelas Leal, V&#46; Alegre de Miquel"
        "autores" => array:4 [
          0 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Fayos Gregori"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Labrandero Hoyos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Pe&#241;uelas Leal"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:4 [
            "nombre" => "V&#46;"
            "apellidos" => "Alegre de Miquel"
            "email" => array:1 [
              0 => "victor.alegre@hotmail.com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Facultad de Medicina&#44; Universitat de Val&#232;ncia&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital General Universitario de Val&#233;ncia&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Reacciones adversas dermatol&#243;gicas en pacientes con terapia dirigida contra inhibidores de la respuesta inmune"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1311
            "Ancho" => 2565
            "Tamanyo" => 202098
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Number and distribution of dermatologic manifestations observed in patients treated with PD-1 and PD-L1 inhibitors&#46; PD indicates programmed death&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The increasingly widespread use of programmed death &#40;PD&#41; 1 and PD ligand &#40;PD-L1&#41; inhibitors to treat cancer has led to growing interest in the need for a detailed knowledge and description of their adverse effects&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#44;2</span></a> Dermatologic adverse effects are the earliest to appear and the most common&#46; While it is known that these effects are caused by activation of T lymphocytes resulting from blockade of the PD-1 receptors and the ligand PD-L1&#44; we still know little of the mechanism underlying the abnormal targeting of dermal-epidermal antigens by immune cells&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4</span></a> Below&#44; we report a series that brings together experience on cutaneous adverse effects associated with these drugs in a reference center&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We selected all patients included in the registry of the Pharmacy Department of Hospital General Universitario de Valencia&#44; Valencia&#44; Spain who had received immune checkpoint inhibitors between 2014 and 2021&#46; The series comprised 313 patients&#44; of whom 10 had received treatment with durvalumab&#44; 139 with pembrolizumab&#44; 112 with nivolumab&#44; 51 with atezolizumab&#44; and 1 with avelumab&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We identified patients whose skin abnormalities could be attributed to the adverse effects of PD-1 or PD-L1 inhibitors&#46; We then collected relevant data to characterize the dermatologic abnormalities found and determined the time between initiation of treatment with immune checkpoint inhibitors and onset&#46; The adverse effects were classified as follows&#58; alopecia&#44; eczema&#44; erythema nodosum&#44; granuloma annulare&#44; lichenoid reactions or lichen planus&#44; pemphigoid&#44; pruritus&#44; psoriasis&#44; palmoplantar pustulosis&#44; sarcoidosis&#44; toxicoderma&#44; vitiligo&#44; and xerosis&#46; We also obtained information on the primary tumor owing to its possible relevance in the onset of adverse effects&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Of the 313 patients analyzed&#44; 40 &#40;12&#37;&#41; had adverse reactions to PD-1 or PD-L1 inhibitors&#46; The highest number of adverse effects was recorded with nivolumab &#40;incidence of 16&#37;&#41;&#44; followed by pembrolizumab &#40;14&#37;&#41;&#46; Of the 51 patients who received atezolizumab exclusively&#44; only 1 experienced an adverse effect&#46; A significantly lower number of dermatologic adverse effects were recorded in patients receiving PD-L1 inhibitors &#40;incidence&#44; 3&#46;2&#37;&#41; than in patients receiving PD-1 inhibitors &#40;15&#46;1&#37;&#41; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#44; <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span>&#41;&#46; All the adverse effects responded favorably to topical and&#47;or systemic treatments&#44; with no need to modify or suspend immunotherapy in any cases&#46; The highest incidence was recorded for melanoma&#44; with adverse effects in 40&#46;8&#37;&#44; compared to only 6&#46;7&#37; in patients with lung cancer&#46; Only 1 adverse effect was detected in 30&#37; of patients&#59; more than 1 effect was recorded in the remaining 70&#37;&#46; Of note&#44; 2 patients developed 6 effects&#58; in both cases the primary tumor was melanoma&#46; The most common cutaneous reaction in the series was pruritus &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25&#41;&#44; followed by vitiligo &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41; and eczema &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The present study made it possible for us to establish an association between the use of PD-1 and PD-L1 inhibitors and the onset of dermatologic adverse effects&#46; The most frequent effects were pruritus&#44; vitiligo&#44; and eczema&#44; as reported elsewhere&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> The size of our sample enabled us to detect effects that are less common&#44; such as sarcoidosis&#44; pustulosis&#44; and bullous pemphigoid&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In the series we studied&#44; we were able to associate the incidence of adverse effects with the type of primary tumor&#44; irrespective of the drug administered&#46; This was particularly true for melanoma&#44; where adverse effects were observed in 40&#37; of affected patients&#59; this incidence was higher than in other studies&#46; However&#44; we cannot rule out selection bias&#44; since patients with melanoma have regular checkups in the dermatology department&#59; therefore&#44; adverse effects affecting the skin and adnexa are more likely to be detected&#46; Furthermore&#44; vitiligo&#44; which is one of the most frequent adverse effects of PD-1 and PD-L1 inhibitors&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> almost exclusively affects patients with melanoma&#44; thus potentially explaining the greater incidence of adverse effects than in patients with other primary tumors&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The onset of adverse effects has been associated with greater survival of affected patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">9&#44;10</span></a> This could be attributed to more potent activation of the immune system&#44; which acts against both tumor cells and healthy tissue&#46; The adverse effects observed were tolerable&#46; Systemic treatment was necessary in more severe manifestations &#40;6 patients with intense pruritus and sleep disturbances&#44; 1 patient with generalized eczema&#44; 1 patient with extensive lichen planus&#44; 2 patients with bullous pemphigoid&#44; and 1 patient with sarcoidosis&#41;&#44; although it was not necessary to suspend immunotherapy in any of them&#46; We must identify and control these adverse effects early so that they do not lead to interruption of treatment&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of Interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1311
            "Ancho" => 2565
            "Tamanyo" => 202098
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Number and distribution of dermatologic manifestations observed in patients treated with PD-1 and PD-L1 inhibitors&#46; PD indicates programmed death&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Review of indications of FDA-approved immune checkpoint inhibitors per NCCN guidelines with the level of evidence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; Vaddepally"
                            1 => "P&#46; Kharel"
                            2 => "R&#46; Pandey"
                            3 => "R&#46; Garje"
                            4 => "A&#46;B&#46; Chandra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Cancers &#40;Basel&#41;"
                        "fecha" => "2020"
                        "volumen" => "123"
                        "paginaInicial" => "738"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous adverse events associated with immune checkpoint inhibitors&#58; a review article"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;H&#46; Chen"
                            1 => "H&#46;S&#46; Yu"
                            2 => "S&#46; Yu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Curr Oncol"
                        "fecha" => "2022"
                        "volumen" => "18"
                        "paginaInicial" => "2871"
                        "paginaFinal" => "2886"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of dermatologic and mucosal adverse events associated with PD-1&#47;PD-L1 inhibitors in cancer patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "W&#46; Yang"
                            1 => "S&#46; Li"
                            2 => "Q&#46; Yang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MD.0000000000015731"
                      "Revista" => array:5 [
                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
                        "fecha" => "2019"
                        "volumen" => "98"
                        "paginaInicial" => "e15731"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31096532"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization and management of dermatologic adverse events to agents targeting the PD-1 receptor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Belum"
                            1 => "B&#46; Benhuri"
                            2 => "M&#46; Postow"
                            3 => "M&#46; Hellmann"
                            4 => "A&#46; Lesokhin"
                            5 => "N&#46; Segal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2016.02.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2016"
                        "volumen" => "60"
                        "paginaInicial" => "12"
                        "paginaFinal" => "25"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27043866"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safety and efficacy of re-treating with immunotherapy after immune-related adverse events in patients with NSCLC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;C&#46; Santini"
                            1 => "H&#46; Rizvi"
                            2 => "A&#46;J&#46; Plodkowski"
                            3 => "A&#46; Ni"
                            4 => "M&#46;E&#46; Lacouture"
                            5 => "M&#46; Gambarin-Gelwan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1158/2326-6066.CIR-17-0755"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Immunol Res"
                        "fecha" => "2018"
                        "volumen" => "6"
                        "paginaInicial" => "1093"
                        "paginaFinal" => "1099"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29991499"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous immune-related adverse events in patients with melanoma treated with checkpoint inhibitors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Gault"
                            1 => "A&#46; Anderson"
                            2 => "R&#46; Plummer"
                            3 => "C&#46; Stewart"
                            4 => "A&#46; Pratt"
                            5 => "N&#46; Rajan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2021"
                        "volumen" => "185"
                        "paginaInicial" => "263"
                        "paginaFinal" => "271"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting PD-1 and PD-L1"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Naidoo"
                            1 => "K&#46; Schindler"
                            2 => "C&#46; Querfeld"
                            3 => "K&#46; Busam"
                            4 => "J&#46; Cunningham"
                            5 => "D&#46;B&#46; Page"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1158/2326-6066.CIR-15-0123"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Immunol Res"
                        "fecha" => "2016"
                        "volumen" => "4"
                        "paginaInicial" => "383"
                        "paginaFinal" => "389"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26928461"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of vitiligo with tumor response in patients with metastatic melanoma treated with pembrolizumab"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Hua"
                            1 => "L&#46; Boussemart"
                            2 => "C&#46; Mateus"
                            3 => "E&#46; Routier"
                            4 => "C&#46; Boutros"
                            5 => "H&#46; Cazenave"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "JAMA Dermatol"
                        "fecha" => "2016"
                        "volumen" => "1521"
                        "paginaInicial" => "45"
                        "paginaFinal" => "51"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nivolumab in resected and unresectable melanoma&#58; immune-related adverse events and association with survival outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;L&#46; Freeman-Keller"
                            1 => "Y&#46; Kim"
                            2 => "H&#46; Cronin"
                            3 => "A&#46; Richards"
                            4 => "G&#46; Gibney"
                            5 => "J&#46;S&#46; Weber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1158/1078-0432.CCR-15-1136"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Cancer Res"
                        "fecha" => "2016"
                        "volumen" => "22"
                        "paginaInicial" => "886"
                        "paginaFinal" => "894"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26446948"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pembrolizumab cutaneous adverse events and their association with disease progression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Sanlorenzo"
                            1 => "I&#46; Vujic"
                            2 => "A&#46; Daud"
                            3 => "A&#46; Algazi"
                            4 => "M&#46; Gubens"
                            5 => "S&#46;A&#46; Luna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamadermatol.2015.1916"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Dermatol"
                        "fecha" => "2015"
                        "volumen" => "151"
                        "paginaInicial" => "1206"
                        "paginaFinal" => "1212"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26222619"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/00017310/0000011400000003/v1_202303051528/S0001731023000534/v1_202303051528/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6160"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Cartas cient&#237;fico-cl&#237;nicas"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011400000003/v1_202303051528/S0001731023000534/v1_202303051528/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023000534?idApp=UINPBA000044"
]
Compartir
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Case and Research Letter
Adverse Dermatologic Reactions in Patients Treated With Immune Checkpoint Inhibitors
Reacciones adversas dermatológicas en pacientes con terapia dirigida contra inhibidores de la respuesta inmune
R. Fayos Gregoria, C. Labrandero Hoyosb, R. Peñuelas Lealb, V. Alegre de Miquela,b,
Autor para correspondencia
victor.alegre@hotmail.com

Corresponding author.
a Facultad de Medicina, Universitat de València, Spain
b Servicio de Dermatología, Hospital General Universitario de Valéncia, Spain
Leído
2288
Veces
se ha leído el artículo
744
Total PDF
1544
Total HTML
Compartir estadísticas
 array:23 [
  "pii" => "S0001731023000534"
  "issn" => "00017310"
  "doi" => "10.1016/j.ad.2022.08.030"
  "estado" => "S300"
  "fechaPublicacion" => "2023-03-01"
  "aid" => "3364"
  "copyrightAnyo" => "2023"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2023;114:T288-T289"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0001731022007864"
    "issn" => "00017310"
    "doi" => "10.1016/j.ad.2022.08.019"
    "estado" => "S300"
    "fechaPublicacion" => "2023-03-01"
    "aid" => "3196"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2023;114:288-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENT&#205;FICO-CL&#205;NICA</span>"
      "titulo" => "Reacciones adversas dermatol&#243;gicas en pacientes con terapia dirigida contra inhibidores de la respuesta inmune"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "288"
          "paginaFinal" => "289"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Adverse Dermatologic Reactions in Patients Treated With Immune Checkpoint Inhibitors"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1273
              "Ancho" => 2508
              "Tamanyo" => 169958
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">N&#250;mero y distribuci&#243;n de manifestaciones dermatol&#243;gicas observadas en pacientes tratados con anti-PD1 y anti-PDL1&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "R&#46; Fayos Gregori, C&#46; Labrandero Hoyos, R&#46; Pe&#241;uelas Leal, V&#46; Alegre de Miquel"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Fayos Gregori"
            ]
            1 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Labrandero Hoyos"
            ]
            2 => array:2 [
              "nombre" => "R&#46; Pe&#241;uelas"
              "apellidos" => "Leal"
            ]
            3 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Alegre de Miquel"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022007864?idApp=UINPBA000044"
    "url" => "/00017310/0000011400000003/v1_202303051528/S0001731022007864/v1_202303051528/es/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:18 [
      "pii" => "S0001731022007864"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2022.08.019"
      "estado" => "S300"
      "fechaPublicacion" => "2023-03-01"
      "aid" => "3196"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2023;114:288-9"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENT&#205;FICO-CL&#205;NICA</span>"
        "titulo" => "Reacciones adversas dermatol&#243;gicas en pacientes con terapia dirigida contra inhibidores de la respuesta inmune"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "288"
            "paginaFinal" => "289"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Adverse Dermatologic Reactions in Patients Treated With Immune Checkpoint Inhibitors"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1273
                "Ancho" => 2508
                "Tamanyo" => 169958
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">N&#250;mero y distribuci&#243;n de manifestaciones dermatol&#243;gicas observadas en pacientes tratados con anti-PD1 y anti-PDL1&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "R&#46; Fayos Gregori, C&#46; Labrandero Hoyos, R&#46; Pe&#241;uelas Leal, V&#46; Alegre de Miquel"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Fayos Gregori"
              ]
              1 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Labrandero Hoyos"
              ]
              2 => array:2 [
                "nombre" => "R&#46; Pe&#241;uelas"
                "apellidos" => "Leal"
              ]
              3 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Alegre de Miquel"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022007864?idApp=UINPBA000044"
      "url" => "/00017310/0000011400000003/v1_202303051528/S0001731022007864/v1_202303051528/es/main.assets"
    ]
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>"
    "titulo" => " Adverse Dermatologic Reactions in Patients Treated With Immune Checkpoint Inhibitors"
    "tieneTextoCompleto" => true
    "saludo" => "To the Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "T288"
        "paginaFinal" => "T289"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "R&#46; Fayos Gregori, C&#46; Labrandero Hoyos, R&#46; Pe&#241;uelas Leal, V&#46; Alegre de Miquel"
        "autores" => array:4 [
          0 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Fayos Gregori"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Labrandero Hoyos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Pe&#241;uelas Leal"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:4 [
            "nombre" => "V&#46;"
            "apellidos" => "Alegre de Miquel"
            "email" => array:1 [
              0 => "victor.alegre@hotmail.com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Facultad de Medicina&#44; Universitat de Val&#232;ncia&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital General Universitario de Val&#233;ncia&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Reacciones adversas dermatol&#243;gicas en pacientes con terapia dirigida contra inhibidores de la respuesta inmune"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1311
            "Ancho" => 2565
            "Tamanyo" => 202098
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Number and distribution of dermatologic manifestations observed in patients treated with PD-1 and PD-L1 inhibitors&#46; PD indicates programmed death&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The increasingly widespread use of programmed death &#40;PD&#41; 1 and PD ligand &#40;PD-L1&#41; inhibitors to treat cancer has led to growing interest in the need for a detailed knowledge and description of their adverse effects&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#44;2</span></a> Dermatologic adverse effects are the earliest to appear and the most common&#46; While it is known that these effects are caused by activation of T lymphocytes resulting from blockade of the PD-1 receptors and the ligand PD-L1&#44; we still know little of the mechanism underlying the abnormal targeting of dermal-epidermal antigens by immune cells&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4</span></a> Below&#44; we report a series that brings together experience on cutaneous adverse effects associated with these drugs in a reference center&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We selected all patients included in the registry of the Pharmacy Department of Hospital General Universitario de Valencia&#44; Valencia&#44; Spain who had received immune checkpoint inhibitors between 2014 and 2021&#46; The series comprised 313 patients&#44; of whom 10 had received treatment with durvalumab&#44; 139 with pembrolizumab&#44; 112 with nivolumab&#44; 51 with atezolizumab&#44; and 1 with avelumab&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We identified patients whose skin abnormalities could be attributed to the adverse effects of PD-1 or PD-L1 inhibitors&#46; We then collected relevant data to characterize the dermatologic abnormalities found and determined the time between initiation of treatment with immune checkpoint inhibitors and onset&#46; The adverse effects were classified as follows&#58; alopecia&#44; eczema&#44; erythema nodosum&#44; granuloma annulare&#44; lichenoid reactions or lichen planus&#44; pemphigoid&#44; pruritus&#44; psoriasis&#44; palmoplantar pustulosis&#44; sarcoidosis&#44; toxicoderma&#44; vitiligo&#44; and xerosis&#46; We also obtained information on the primary tumor owing to its possible relevance in the onset of adverse effects&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Of the 313 patients analyzed&#44; 40 &#40;12&#37;&#41; had adverse reactions to PD-1 or PD-L1 inhibitors&#46; The highest number of adverse effects was recorded with nivolumab &#40;incidence of 16&#37;&#41;&#44; followed by pembrolizumab &#40;14&#37;&#41;&#46; Of the 51 patients who received atezolizumab exclusively&#44; only 1 experienced an adverse effect&#46; A significantly lower number of dermatologic adverse effects were recorded in patients receiving PD-L1 inhibitors &#40;incidence&#44; 3&#46;2&#37;&#41; than in patients receiving PD-1 inhibitors &#40;15&#46;1&#37;&#41; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#44; <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span>&#41;&#46; All the adverse effects responded favorably to topical and&#47;or systemic treatments&#44; with no need to modify or suspend immunotherapy in any cases&#46; The highest incidence was recorded for melanoma&#44; with adverse effects in 40&#46;8&#37;&#44; compared to only 6&#46;7&#37; in patients with lung cancer&#46; Only 1 adverse effect was detected in 30&#37; of patients&#59; more than 1 effect was recorded in the remaining 70&#37;&#46; Of note&#44; 2 patients developed 6 effects&#58; in both cases the primary tumor was melanoma&#46; The most common cutaneous reaction in the series was pruritus &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25&#41;&#44; followed by vitiligo &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41; and eczema &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The present study made it possible for us to establish an association between the use of PD-1 and PD-L1 inhibitors and the onset of dermatologic adverse effects&#46; The most frequent effects were pruritus&#44; vitiligo&#44; and eczema&#44; as reported elsewhere&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> The size of our sample enabled us to detect effects that are less common&#44; such as sarcoidosis&#44; pustulosis&#44; and bullous pemphigoid&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In the series we studied&#44; we were able to associate the incidence of adverse effects with the type of primary tumor&#44; irrespective of the drug administered&#46; This was particularly true for melanoma&#44; where adverse effects were observed in 40&#37; of affected patients&#59; this incidence was higher than in other studies&#46; However&#44; we cannot rule out selection bias&#44; since patients with melanoma have regular checkups in the dermatology department&#59; therefore&#44; adverse effects affecting the skin and adnexa are more likely to be detected&#46; Furthermore&#44; vitiligo&#44; which is one of the most frequent adverse effects of PD-1 and PD-L1 inhibitors&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> almost exclusively affects patients with melanoma&#44; thus potentially explaining the greater incidence of adverse effects than in patients with other primary tumors&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The onset of adverse effects has been associated with greater survival of affected patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">9&#44;10</span></a> This could be attributed to more potent activation of the immune system&#44; which acts against both tumor cells and healthy tissue&#46; The adverse effects observed were tolerable&#46; Systemic treatment was necessary in more severe manifestations &#40;6 patients with intense pruritus and sleep disturbances&#44; 1 patient with generalized eczema&#44; 1 patient with extensive lichen planus&#44; 2 patients with bullous pemphigoid&#44; and 1 patient with sarcoidosis&#41;&#44; although it was not necessary to suspend immunotherapy in any of them&#46; We must identify and control these adverse effects early so that they do not lead to interruption of treatment&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of Interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1311
            "Ancho" => 2565
            "Tamanyo" => 202098
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Number and distribution of dermatologic manifestations observed in patients treated with PD-1 and PD-L1 inhibitors&#46; PD indicates programmed death&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Review of indications of FDA-approved immune checkpoint inhibitors per NCCN guidelines with the level of evidence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; Vaddepally"
                            1 => "P&#46; Kharel"
                            2 => "R&#46; Pandey"
                            3 => "R&#46; Garje"
                            4 => "A&#46;B&#46; Chandra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Cancers &#40;Basel&#41;"
                        "fecha" => "2020"
                        "volumen" => "123"
                        "paginaInicial" => "738"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous adverse events associated with immune checkpoint inhibitors&#58; a review article"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;H&#46; Chen"
                            1 => "H&#46;S&#46; Yu"
                            2 => "S&#46; Yu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Curr Oncol"
                        "fecha" => "2022"
                        "volumen" => "18"
                        "paginaInicial" => "2871"
                        "paginaFinal" => "2886"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of dermatologic and mucosal adverse events associated with PD-1&#47;PD-L1 inhibitors in cancer patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "W&#46; Yang"
                            1 => "S&#46; Li"
                            2 => "Q&#46; Yang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MD.0000000000015731"
                      "Revista" => array:5 [
                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
                        "fecha" => "2019"
                        "volumen" => "98"
                        "paginaInicial" => "e15731"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31096532"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization and management of dermatologic adverse events to agents targeting the PD-1 receptor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Belum"
                            1 => "B&#46; Benhuri"
                            2 => "M&#46; Postow"
                            3 => "M&#46; Hellmann"
                            4 => "A&#46; Lesokhin"
                            5 => "N&#46; Segal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2016.02.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2016"
                        "volumen" => "60"
                        "paginaInicial" => "12"
                        "paginaFinal" => "25"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27043866"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safety and efficacy of re-treating with immunotherapy after immune-related adverse events in patients with NSCLC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;C&#46; Santini"
                            1 => "H&#46; Rizvi"
                            2 => "A&#46;J&#46; Plodkowski"
                            3 => "A&#46; Ni"
                            4 => "M&#46;E&#46; Lacouture"
                            5 => "M&#46; Gambarin-Gelwan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1158/2326-6066.CIR-17-0755"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Immunol Res"
                        "fecha" => "2018"
                        "volumen" => "6"
                        "paginaInicial" => "1093"
                        "paginaFinal" => "1099"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29991499"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous immune-related adverse events in patients with melanoma treated with checkpoint inhibitors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Gault"
                            1 => "A&#46; Anderson"
                            2 => "R&#46; Plummer"
                            3 => "C&#46; Stewart"
                            4 => "A&#46; Pratt"
                            5 => "N&#46; Rajan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2021"
                        "volumen" => "185"
                        "paginaInicial" => "263"
                        "paginaFinal" => "271"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting PD-1 and PD-L1"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Naidoo"
                            1 => "K&#46; Schindler"
                            2 => "C&#46; Querfeld"
                            3 => "K&#46; Busam"
                            4 => "J&#46; Cunningham"
                            5 => "D&#46;B&#46; Page"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1158/2326-6066.CIR-15-0123"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Immunol Res"
                        "fecha" => "2016"
                        "volumen" => "4"
                        "paginaInicial" => "383"
                        "paginaFinal" => "389"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26928461"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of vitiligo with tumor response in patients with metastatic melanoma treated with pembrolizumab"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Hua"
                            1 => "L&#46; Boussemart"
                            2 => "C&#46; Mateus"
                            3 => "E&#46; Routier"
                            4 => "C&#46; Boutros"
                            5 => "H&#46; Cazenave"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "JAMA Dermatol"
                        "fecha" => "2016"
                        "volumen" => "1521"
                        "paginaInicial" => "45"
                        "paginaFinal" => "51"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nivolumab in resected and unresectable melanoma&#58; immune-related adverse events and association with survival outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;L&#46; Freeman-Keller"
                            1 => "Y&#46; Kim"
                            2 => "H&#46; Cronin"
                            3 => "A&#46; Richards"
                            4 => "G&#46; Gibney"
                            5 => "J&#46;S&#46; Weber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1158/1078-0432.CCR-15-1136"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Cancer Res"
                        "fecha" => "2016"
                        "volumen" => "22"
                        "paginaInicial" => "886"
                        "paginaFinal" => "894"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26446948"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pembrolizumab cutaneous adverse events and their association with disease progression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Sanlorenzo"
                            1 => "I&#46; Vujic"
                            2 => "A&#46; Daud"
                            3 => "A&#46; Algazi"
                            4 => "M&#46; Gubens"
                            5 => "S&#46;A&#46; Luna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamadermatol.2015.1916"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Dermatol"
                        "fecha" => "2015"
                        "volumen" => "151"
                        "paginaInicial" => "1206"
                        "paginaFinal" => "1212"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26222619"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/00017310/0000011400000003/v1_202303051528/S0001731023000534/v1_202303051528/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6160"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Cartas cient&#237;fico-cl&#237;nicas"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011400000003/v1_202303051528/S0001731023000534/v1_202303051528/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023000534?idApp=UINPBA000044"
]
Información del artículo
ISSN: 00017310
Idioma original: Inglés
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 13 8 21
2024 Octubre 120 53 173
2024 Septiembre 121 33 154
2024 Agosto 123 64 187
2024 Julio 91 42 133
2024 Junio 117 50 167
2024 Mayo 92 38 130
2024 Abril 77 40 117
2024 Marzo 61 37 98
2024 Febrero 41 21 62
2024 Enero 37 24 61
2023 Diciembre 39 19 58
2023 Noviembre 42 22 64
2023 Octubre 44 32 76
2023 Septiembre 41 24 65
2023 Agosto 48 17 65
2023 Julio 49 31 80
2023 Junio 55 19 74
2023 Mayo 45 34 79
2023 Abril 66 28 94
2023 Marzo 146 50 196
2023 Febrero 63 35 98
2023 Enero 13 23 36
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

Idiomas
Actas Dermo-Sifiliográficas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?