Wang LL, et al. - Experts ascertained the timing of cutaneous drug reactions after initiation of programmed cell death (PD-1) inhibitor therapy. Findings suggested the probable presence of diverse cutaneous adverse reactions secondary to PD-1 inhibitor use with delayed onsets and even after discontinuation of therapy. An awareness regarding the potential for delayed presentations of cutaneous adverse reactions should be created among the dermatologists.

Methods

• In this retrospective observational study, researchers included patients referred to an academic dermatology clinic by an oncologist from January 1, 2014, through February 28, 2018, with at least 1 skin biopsy specimen of a skin reaction associated with PD-1 inhibitor use.
• They included the participants if they had a biopsy-proven cutaneous reaction in response to a PD-1 inhibitor used alone or in combination with ipilimumab.
• Pembrolizumab, nivolumab, or nivolumab with ipilimumab as immunotherapy for cancer were received by all patients included in this study.
• Time to onset of biopsy-proven cutaneous reactions that occurred during or after use of pembrolizumab or nivolumab was the main outcome measure.

Results

• Findings suggested that a total of 17 patients (12 men, 5 women; mean [SD] age, 68.6 [11.1] years) were identified who presented with cutaneous adverse reactions associated with PD-1 inhibitor therapy; these reactions included lichenoid dermatitis, bullous pemphigoid, erythema multiforme, eczema, lupus, and sarcoidosis.
• Reactions were presented by 12 patients with at least 3 months after beginning pembrolizumab or nivolumab therapy.
• Results demonstrated that a median (range) of 4.2 months (0.5-38.0 months) after drug initiation was presented by the skin reactions.
• As per data, the cutaneous adverse reactions in 5 cases attributed to the PD-1 inhibitor therapy developed after the drug therapy was terminated.