Dermatologic infections in cancer patients treated with checkpoint inhibitors - 08/04/21
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Abstract |
Background |
The incidence of dermatologic infections in patients receiving checkpoint inhibitors (CPIs) has not been systematically described.
Objective |
Identify the incidence of dermatologic infections in patients who received CPIs.
Methods |
Retrospective review of dermatologic infections in patients who received CPIs between 2005 and 2020 and were evaluated by dermatologists at Memorial Sloan Kettering Cancer Center.
Results |
Of 2061 patients in the study, 1292 were actively receiving CPIs (≤ 90 days since the last dose) and 769 had previously been on CPIs (> 90 days since the last dose). The dermatologic infection rate was significantly higher in patients with active CPI treatment (17.5%) than in patients not actively being treated (8.2%; P < .0001). In patients on CPIs, 82 (36.2%), 78 (34.5%), and 48 (21.2%) had bacterial, fungal, and viral infections, respectively, and 18 (8.0%) had polymicrobial infections. Anti-cytotoxic T-lymphocyte-associated antigen-4 monotherapy was associated with the highest risk of infection (hazard ratio, 2.93; 95% confidence interval, 1.87 to 4.60; P < .001).
Limitations |
Retrospective design and sample limited to patients referred to dermatology.
Conclusions |
Patients actively receiving CPIs are more susceptible to dermatologic infections, with anti-cytotoxic T-lymphocyte-associated antigen-4 monotherapy carrying the highest risk, suggesting that the index of suspicion for infections should be increased in these patients to minimize morbidity and optimize care.
Le texte complet de cet article est disponible en PDF.Key words : anti-CTLA-4, anti-PD-1, anti-PD-L1, cancer, checkpoint inhibitors, dermatologic infections
Abbreviations used : CPI, CTLA-4, irAEs, PD-1, PD-L1
Plan
Funding sources: This work was supported in part by the National Cancer Institute at the National Institutes of Health (P30 CA008748); Dr Lacouture received support from the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health (U01 AR077511); Dr Do received support from the National Institutes of Health (T32 GM007739 and F30 AI129273-03); and Dr Markova received supported from the Dermatology Foundation Medical Dermatology Career Development Award. |
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IRB approval status: Approved by the Institutional Review Board of Memorial Sloan Kettering Cancer Center (MSKCC, IRB # 16-458). |
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Reprints not available from the authors. |
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