As the incidence of cutaneous malignancies continues to rise and their treatment with immunotherapy expands, dermatologists and their patients are more likely to encounter immune checkpoint inhibitors. While the blockade of immune checkpoint target proteins (cytotoxic T-lymphocyte–associated protein-4, programmed cell death-1, and programmed cell death ligand-1) generates an antitumor response in a substantial fraction of patients, there is a critical need for reliable predictive biomarkers and approaches to address refractory disease. The first article of this Continuing Medical Education series reviews the indications, efficacy, safety profile, and evidence supporting checkpoint inhibition as therapeutics for metastatic melanoma, cutaneous squamous cell carcinoma, and Merkel cell carcinoma. Pivotal studies resulting in the approval of ipilimumab, pembrolizumab, nivolumab, cemiplimab, and avelumab by regulatory agencies for various cutaneous malignancies, as well as ongoing clinical research trials, are discussed.Le texte complet de cet article est disponible en PDF.
Key words : basal cell carcinoma, checkpoint inhibitor, CTLA-4 inhibitor, cutaneous lymphomas, cutaneous malignancies, cutaneous squamous cell carcinoma, immunotherapy, Kaposi sarcoma, melanoma, Merkel cell carcinoma, PD-1 inhibitor, PD-L1 inhibitor, skin cancer
Abbreviations used : AE, BCC, CAC, CPI, cSCC, CTLA-4, FDA, irAE, MCC, ORR, PD-1, PD-L1, PFS
| Supported by National Cancer Institute Cancer Center support grant P30 CA008748 and National Institute of Arthritis and Musculoskeletal and Skin Diseases grant U01AR07751 (to Dr Lacouture) and National Cancer Institute grant 5P01CA225517 (to Drs Akaike and Nghiem).
| Conflicts of interest: Dr Postow receives consulting fees (2015-present) from BMS, Merck, Array BioPharma, Novartis, Incyte, NewLink Genetics, and Aduro; receives honoraria from BMS and Merck; and receives institutional support from RGenix, Infinity, BMS, Merck, Array BioPharma, Novartis, and AstraZeneca. Dr Nghiem receives consulting fees from EMD Serono, Merck, and Gegeneron/Sanofi/Genzyme and receives research support to his institution from BMS and EMD Serono. Dr Lacouture has consultant/speaking roles with ADC Therapeutics America, Inc, Apricity Health, LLC, Azitra, Inc, Deciphera, Johnson and Johnson, NCODA, Novocure Inc, Kyowa Kirin, Inc, Janssen Research and Development LLC, Menlo Therapeutics, Novartis Pharmaceuticals Corp, QED Therapeutics, F. Hoffmann-La Roche AG, Amgen Inc, Astrazeneca Pharmaceuticals LP, Genentech Inc, Seattle Genetics, Lutris, Paxman Coolers, Teva Mexico, Parexel, OnQuality Pharmaceuticals Ltd, Oncodermatology, and Takeda Millenium and receives research funding from Lutris, Paxman, Novocure Inc, US Biotest, and Veloce. Ms Barrios, Mr Phillips, and Drs Do and Akaike have no conflicts of interest to disclose.
| Date of release: November 2020
| Expiration date: November 2023