Allegra Alessandro, Di Salvo Eleonora, Casciaro Marco, Musolino Caterina, Pioggia Giovanni, Gangemi Sebastiano
Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 98125 Messina, Italy.
Department of Veterinary Sciences, University of Messina, 98125 Messina, Italy.
Biomedicines. 2020 Dec 22;9(1):2. doi: 10.3390/biomedicines9010002.
Although pruritus may sometimes be a consequential situation to neoplasms, it more frequently emerges after commencing chemotherapy. In this review, we present our analysis of the chemotherapy treatments that most often induce skin changes and itching. After discussing conventional chemotherapies capable of inducing pruritus, we present our evaluation of new drugs such as immunological checkpoint inhibitors (ICIs), tyrosine kinase inhibitors, and monoclonal antibodies. Although ICIs and targeted therapy are thought to damage tumor cells, these therapies can modify homeostatic events of the epidermis and dermis, causing the occurrence of cutaneous toxicities in treated subjects. In the face of greater efficacy, greater skin toxicity has been reported for most of these drugs. A remarkable aspect of some reports is the presence of a probable correlation between cutaneous toxicity and treatment effectiveness in tumor patients who were treated with novel drugs such as nivolumab or pembrolizumab. Findings from these experiments demonstrate that the occurrence of any grade of skin side effects can be considered as a predictor of a better outcome. In the near future, studies on the relationship between the onset of skin alterations and outcomes could open new perspectives on the treatment of neoplasms through specific target therapy.
尽管瘙痒有时可能是肿瘤的一种继发情况，但它更常在开始化疗后出现。在本综述中，我们展示了对最常引起皮肤变化和瘙痒的化疗治疗的分析。在讨论了能够引起瘙痒的传统化疗后，我们展示了对免疫检查点抑制剂（ICIs）、酪氨酸激酶抑制剂和单克隆抗体等新药的评估。尽管ICIs和靶向治疗被认为会损害肿瘤细胞，但这些疗法会改变表皮和真皮的稳态事件，导致治疗对象出现皮肤毒性。面对更高的疗效，据报道这些药物中的大多数具有更大的皮肤毒性。一些报告的一个显著方面是，在接受纳武单抗或派姆单抗等新药治疗的肿瘤患者中，皮肤毒性与治疗效果之间可能存在相关性。这些实验的结果表明，任何级别的皮肤副作用的出现都可被视为更好预后的一个预测指标。在不久的将来，关于皮肤改变的发生与预后之间关系的研究可能会通过特定的靶向治疗为肿瘤治疗开辟新的前景。
