Bullous disorders associated with anti–PD-1 and anti–PD-L1 therapy: A retrospective analysis evaluating the clinical and histopathologic features, frequency, and impact on cancer therapy - 10/11/18
Abstract |
Background |
Bullous disorders associated with anti–programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) therapy are increasingly reported and may pose distinct therapeutic challenges. Their frequency and impact on cancer therapy are not well established.
Objective |
To evaluate the clinical and histopathologic findings, frequency, and impact on cancer therapy of bullous eruptions due to anti–PD-1/PD-L1 therapy.
Methods |
We retrospectively reviewed the medical records of patients evaluated by the oncodermatology clinic and consultative service of Yale New Haven Hospital from 2016 to 2018.
Results |
We identified 9 of 853 patients who developed bullous eruptions (∼1%) that were treated with anti–PD-1/PD-L1 therapy at our institution during the study period: 7 presented with bullous pemphigoid, 1 presented with bullous lichenoid dermatitis, and 1 presented with linear IgA bullous dermatosis in the context of vancomycin therapy. In all, 8 patients required systemic steroids, 5 required maintenance therapy, and 8 required interruption of immunotherapy. All 9 patients had an initial positive tumor response or stable disease, but 4 went on to develop disease progression.
Limitations |
This was a retrospective study from a single tertiary care center.
Conclusions |
Bullous disorders developed in approximately 1% of patients treated with anti–PD-1/PD-L1 therapy at our institution and frequently resulted in interruption of immune therapy and management with systemic corticosteroids and occasionally steroid-sparing agents.
Le texte complet de cet article est disponible en PDF.Key words : bullous pemphigoid, immunotherapy, medical dermatology, programmed cell death 1, programmed cell death ligand 1
Abbreviations used : BP, BP180, DEJ, DIF, IIF, irAE, LABD, PD-1, PD-L1
Plan
| Drs Tomayko and Leventhal contributed equally to this article and served as cosenior authors. |
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| Funding sources: None. |
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| Disclosure: Dr Goldberg has served on an advisory board for AstraZeneca, Bristol-Myers Squibb, Eli Lilly and Company, and Boehringer Ingelheim. Dr Decker has served on an advisory board for and received research funding from Merck & Co. Dr Petrylak has received research funding from Agensys, AstraZeneca, Bayer, Clovis, Dendreon, Eli Lilly and Company, Endocyte, Genentech, Innocrin, Johnson & Johnson, MedImmune, Medivation, Merck, Millineum, Novartis, Pfizer, Progenics, Roche Laboratories, Sanofi Aventis, and Sotio and has served as a consultant for Astellas, AstraZeneca, Bayer, Bellicum, Dendreon, Exelixis, Ferring, Johnson and Johnson, Eli Lilly and Company, Medivation, Millineum, Pfizer, Roche Laboratories, and Sanofi Aventis. Dr Leventhal has served on an advisory board for Amgen. Dr Siegel, Dr Totonchy, Dr Damsky, Ms Berk-Krauss, Dr Castiglione, Dr Sznol, Dr Fischbach, Dr Goldberg, Dr Stamatouli, Dr Hafez, Dr Glusac, and Dr Tomayko have no conflicts of interest to disclose. |
Vol 79 - N° 6
P. 1081-1088 - décembre 2018 Retour au numéro
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