Immune checkpoint inhibitors that cause adverse cutaneous side effects: etiology, management, and monitoring

Introduction: As more and more effective anticancer medications, immune checkpoint inhibitors (ICPi) that are humanized monoclonal to the antigens programmed cell death ۱ (PD-۱) and programmed cell death ligand-۱ (PD-L۱) (atezolizumab, avelumab, and durvalumab) is being employed. Anti-PD-۱/PD-L۱ therapy leads to stimulation of cytotoxic CD۴+/CD۸+ T cells and subsequent cancer cell death, which has specific immunologic adverse effects that are exclusive to this therapy. These drugs are recognized to have the most prevalent immune-related adverse effects, and they can cause a range of cutaneous reactions (irAEs). Most cutaneous irAEs range from ambiguous skin eruptions to obvious skin signs. While some of these cutaneous irAEs may be self-limiting and have tolerable skin toxicity profiles, others may have adverse effects that might even be lethal.Purpose: This study seeks to provide light on the relevant mechanism(s), treatment, and associated cutaneous irAEs of oncology-related medications.fields represented: Several databases, including Pub-Med, Google Scholar, and Medline, were used to search the literature. Research publications, retrospective studies, case reports, and clinicopathological results made up the bulk of the search. This review paper provides a summary of the cutaneous irAEs associated with anti-PD-۱/PD-L۱ therapy as well as recommendations to aid in better managing these side effects and avoiding treatment termination. HIGHLIGHTS The majority of immune-related adverse events brought on by anti-PD-۱/PD-L۱ immune-checkpoint antibodies are instantaneous adverse effects. Most cutaneous toxicities present as maculopapular rash and pruritus. Additionally, more specialized skin issues such as vitiligo, aggravated psoriasis, lichenoid dermatitis, mucosal involvement (such as an oral lichenoid response), dermatomyositis, and lupus erythematosus might develop. Skin symptoms, such as Stevens-Johnson syndrome and toxic epidermal necrolysis, can be fatal (TEN). Skin toxicities are typically minor, easily controlled, and seldom cause major morbidity. Inadequate care of the cutaneous adverse event and early detection may prevent the lesions from getting worse and reduce treatment interruption.

کلیدواژه ها:

Cutaneous eruptions ، anti-PD-۱ ، anti-PD-L۱ ، atezolizumab ، avelumab ، durvalumab ، immune-related adverse events (irAEs) ، immunotherapy ، nivolumab ، oncology ، pembrolizumab