Korean J Dermatol.  2021 May;59(4):251-258.

Analysis of the Dermatologic Side Effects and the Factors Affecting the Efficacy of Immune Checkpoint Inhibitor in Melanoma: A Single-Center, Retrospective Study

• Yoon D
• Oh SJ
• Kim HJ
• Park JH
• Lee JH
• Lee DY
• Lee JH

Abstract

Background
Programmed death 1 inhibitors enhance pre-existing immune responses by directly blocking anti-programmed cell death receptor-1. They have been widely used these days, but little is known about the dermatologic side effects and the factors affecting the response to therapy.
Objective
To determine the association between dermatologic side effects and oncologic response to programmed death 1 inhibitors and to investigate the factors affecting the response to programmed death 1 inhibitors.
Methods
We retrospectively reviewed the records of patients with melanoma who were referred to the dermatology department for their newly arising skin lesions after treatment with pembrolizumab and nivolumab from January 1, 2015, to April 30, 2019. The oncologic outcomes of the patients were determined by medical records from the hemato-oncology department. Sex, stage, dermatologic side effects, and age at the time of initial diagnosis were analyzed as the factors affecting oncologic outcomes. Progression-free survival was analyzed between the patients with and those without dermatologic side effects.
Results
Of the 177 patients screened for the study, 14 were referred to the dermatology department for cutaneous side effects. There was no difference between the dermatologic side effect group and the non-dermatologic side effect group in terms of oncologic outcome and progression-free survival. Sex and stage significantly increased the risk of disease progression with pembrolizumab treatment.
Conclusion
Although it has been reported that there could be a strong association between dermatologic side effects and oncologic outcomes, we were not able to reach the same conclusion among melanoma patients.

Keyword

Drug-related side effects and adverse reactions; Immune checkpoint inhibitors; Immunotherapy; Melanoma; Nivolumab; Pembrolizumab