Internal Medicine Residency Program, Providence Portland Medical Center, Portland, Oregon, USA.
Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas, USA.
J Cutan Pathol. 2023 Jan;50(1):72-95. doi: 10.1111/cup.14327. Epub 2022 Oct 3.
Since their first approval 25 years ago, monoclonal antibodies (mAbs) have become important targeted cancer therapeutics. However, dermatologic toxicities associated with non-immune checkpoint inhibitor (non-ICI) mAbs may complicate the course of cancer treatment. Data on the incidence and types of these reactions are limited.
A comprehensive review was conducted on dermatologic toxicities associated with different classes of non-ICI mAbs approved for treatment of solid tumors and hematologic malignancies. The review included prospective Phase 1, 2, and 3 clinical trials; retrospective literature reviews; systematic reviews/meta-analyses; and case series/reports.
Dermatologic toxicities were associated with several types of non-ICI mAbs. Inflammatory reactions were the most common dermatologic toxicities, manifesting as maculopapular, urticarial, papulopustular/acneiform, and lichenoid/interface cutaneous adverse events (cAEs) with non-ICI mAbs. Immunobullous reactions were rare and a subset of non-ICI mAbs were associated with the development of vitiligo cAEs.
Dermatologic toxicities of non-ICI mAbs are diverse and mostly limited to inflammatory reactions. Awareness of the spectrum of the histopathologic patterns of cAE from non-ICI mAbs therapy is critical in the era of oncodermatology and oncodermatopathology.
自 25 年前首次获得批准以来，单克隆抗体 (mAb) 已成为重要的靶向癌症治疗药物。然而，与非免疫检查点抑制剂 (非 ICI) mAb 相关的皮肤科毒性可能会使癌症治疗过程复杂化。这些反应的发生率和类型的数据有限。
对用于治疗实体瘤和血液恶性肿瘤的不同类别的非 ICI mAb 相关的皮肤科毒性进行了全面的综述。该综述包括前瞻性的 1、2 和 3 期临床试验、回顾性文献综述、系统评价/荟萃分析和病例系列/报告。
皮肤科毒性与多种类型的非 ICI mAb 相关。炎症反应是最常见的皮肤科毒性，表现为斑丘疹、荨麻疹、丘疹脓疱/痤疮样和苔藓样/界面性皮肤不良事件 (cAE)，与非 ICI mAb 有关。免疫性大疱性反应罕见，亚组非 ICI mAb 与白癜风 cAE 的发生有关。
非 ICI mAb 的皮肤科毒性多种多样，主要限于炎症反应。在肿瘤皮肤病学和肿瘤皮肤病病理学时代，了解非 ICI mAb 治疗的 cAE 的组织病理学模式谱至关重要。
