Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.
Department of Dermatology, Dermatological Radiotherapy and Dermatohistopathology, Special Clinics Hornheide, Münster, Germany.
J Eur Acad Dermatol Venereol. 2022 Jan;36 Suppl 1:23-28. doi: 10.1111/jdv.17402.
Immune checkpoint inhibitors (ICI) have shown very promising results in the management of patients with inoperable or metastatic cutaneous squamous cell carcinoma (cSCC). However, ICI can cause a range of immune-related adverse events (irAEs) affecting a multitude of organs including skin, gastrointestinal tract, endocrine system, heart, lung, kidneys and the nervous system. In principle, clinical management irAEs does not change significantly with respect to the kind of cancer treated with ICI. However, advanced cSCC typically occurs in a clinically challenging patient population typically presenting with advanced age and/or significant comorbidities such as immunosuppression due to haematological malignancies and their respective treatment. Moreover, many patients with advanced cSCC are organ transplant patients taking immunosuppressants. As a consequence use of ICI per se and management of ICI-induced irAEs generates more complexity and difficulties in patients with cSCC compared to other entities. Here, we provide a brief review on the management of anti-programmed cell death protein 1-induced irAEs in patients with cSCC focusing on the characteristic clinical challenges present in this population.
免疫检查点抑制剂 (ICI) 在不可切除或转移性皮肤鳞状细胞癌 (cSCC) 患者的治疗中显示出非常有前景的结果。然而，ICI 可引起一系列影响包括皮肤、胃肠道、内分泌系统、心脏、肺、肾脏和神经系统在内的多种器官的免疫相关不良反应 (irAE)。原则上，ICI 治疗的癌症种类并不会显著改变 irAE 的临床管理。然而，晚期 cSCC 通常发生在临床挑战性较大的患者群体中，这些患者通常年龄较大，且存在多种合并症，如血液恶性肿瘤及其相应治疗引起的免疫抑制。此外，许多晚期 cSCC 患者是接受免疫抑制治疗的器官移植患者。因此，与其他实体瘤相比，ICI 的应用本身和 ICI 诱导的 irAE 的管理在 cSCC 患者中会产生更多的复杂性和困难。在这里，我们简要回顾了抗程序性死亡蛋白 1 诱导的 irAE 在 cSCC 患者中的管理，重点关注了该人群中存在的特征性临床挑战。
