Weill Cornell Medical College, New York, NY, USA; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Albert Einstein College of Medicine, Bronx, NY, USA.
Crit Rev Oncol Hematol. 2022 Jun;174:103696. doi: 10.1016/j.critrevonc.2022.103696. Epub 2022 May 6.
The scope of dermatologic adverse events to ibrutinib has not been systematically described. We sought to determine the incidence and severity of ibrutinib-associated dermatologic toxicities and provide management recommendations. We conducted a systematic literature search of clinical trials and cohorts investigating ibrutinib monotherapy for cancer or chronic graft-versus-host disease through June 2020. Thirty-two studies with 2258 patients were included. The incidence of all-grade toxicities included cutaneous bleeds (24.8%; 95%CI, 18.6-31.0%), mucocutaneous infections (4.9%; 95%CI, 2.9-7.0%), rash (10.8%; 95%CI. 6.1-15.5%), mucositis (6%; 95%CI, 3.6-8.5%), edema (15.9%; 95%CI, 11.1-20.6%), pruritus (4.0%; 95%CI, 0.0-7.9%), xerosis (9.2%; 95%CI, 5.5-13.0%), nail changes (17.8%; 95%CI, 4.1-31.5%), and hair changes (7.9%; 95%CI, 0.0-21.3%). The incidence of high-grade toxicities included mucocutaneous infection (1.3%; 95%CI, 0.5-2.2%), rash (0.1%; 95%CI, 0.0-0.2%), mucositis (0.1%; 95%CI, 0.0-0.3%), and edema (0.1%; 95%CI, 0.0-0.2%). It is imperative that clinicians familiarize themselves with ibrutinib-associated dermatologic toxicities to learn how to manage them, prevent discontinuation, and improve patient outcomes.
伊布替尼相关皮肤不良事件的范围尚未得到系统描述。我们旨在确定伊布替尼相关皮肤毒性的发生率和严重程度，并提供管理建议。我们对截至 2020 年 6 月的临床研究和队列研究进行了系统的文献检索，以评估伊布替尼单药治疗癌症或慢性移植物抗宿主病的效果。共纳入 32 项研究，涉及 2258 例患者。所有分级毒性的发生率包括皮肤出血（24.8%；95%CI，18.6-31.0%）、黏膜皮肤感染（4.9%；95%CI，2.9-7.0%）、皮疹（10.8%；95%CI，6.1-15.5%）、黏膜炎（6%；95%CI，3.6-8.5%）、水肿（15.9%；95%CI，11.1-20.6%）、瘙痒（4.0%；95%CI，0.0-7.9%）、干燥症（9.2%；95%CI，5.5-13.0%）、指甲改变（17.8%；95%CI，4.1-31.5%）和毛发改变（7.9%；95%CI，0.0-21.3%）。高分级毒性的发生率包括黏膜皮肤感染（1.3%；95%CI，0.5-2.2%）、皮疹（0.1%；95%CI，0.0-0.2%）、黏膜炎（0.1%；95%CI，0.0-0.3%）和水肿（0.1%；95%CI，0.0-0.2%）。临床医生必须熟悉伊布替尼相关皮肤毒性，以便学会如何管理这些毒性，预防停药，并改善患者预后。
