Original articleSurvival and prognosis of individuals receiving programmed cell death 1 inhibitor with and without immunologic cutaneous adverse events
Section snippets
Study design
This was a prospective study of adults with unresectable stage IIIC-IV metastatic melanoma treated with PD-1 (pembrolizumab and nivolumab) at or above the Food and Drug Administration–approved doses during May 1, 2012-February 1, 2018, at Westmead Hospital, Sydney, Australia. All patients were part of a clinical trial or receiving therapy on compassionate grounds. The study was approved by the Westmead Hospital Human Research Ethics Committees (HERC LNR/13/WMEAD/418). All patients received ≥1
Patient characteristics
A total of 82 patients were included in this study; 5 patients received nivolumab and 77 pembrolizumab. The mean age was 59.9 (standard deviation 12.7, range 19-82) years, and 51 (62%) patients were men (Table I). The median follow-up duration was 40.7 months, with the maximum being 47.3 months.
The incidence of eczema, lichenoid reaction, and vitiligo-like depigmentation
During the follow-up period, 33 patients had ≥1 of the 3 skin reactions of interest (Fig 1). Approximately one-third of these individuals (n = 10) also experienced a second skin reaction, and 2 patients
Discussion
This current study builds upon the previously published data by Hwang et al at the same institution.11 The extended period of observation and follow-up was included in this study. The previous study identified that the 3 most common immune-related adverse events among patients receiving PD-1 treatment were lichenoid reactions, eczema, and vitiligo-like depigmentation. It is generally accepted that all 3 conditions are mediated by lymphocyte damage.1, 11, 14, 19
Dermatitis has been proposed as a
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Cited by (0)
Ms Chan and Ms Hwang contributed equally in this study.
Funding sources: None.
Conflicts of interest: None disclosed.
Reprints not available from the authors.