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晚期黑色素瘤患者免疫治疗的皮肤不良反应

Cutaneous Adverse Reactions of Immunotherapy in Patients with Advanced Melanoma.

作者信息

Nikolaou Vasiliki, Tsimpidakis Antonis, Stratigos Alexander

机构信息

1st Dermatology Department, "Andreas Syggros" Hospital for Skin Diseases, National & Kapodistrian University of Athens, 16121 Athens, Greece.

出版信息

Cancers (Basel). 2023 Mar 31;15(7):2084. doi: 10.3390/cancers15072084.

Abstract

Immune checkpoint blockers (ICBs) have been widely used during the last decade for the treatment of various tumors, including advanced and metastatic melanoma. While these agents have improved melanoma patients' survival rates, they have also been associated with various autoimmune toxicities, with the skin being most commonly affected. The severity of cutaneous toxicity can not only negatively affect patients' quality of life but can also limit the proper treatment of cancer. Thus, the role of the dermatologist is substantial in early detecting and promptly treating these adverse events. Maculopapular rash, psoriasiform, lichenoid dermatoses and bullous pemphigoid are the most frequent cutaneous adverse events that require immediate intervention. Other rare autoimmune toxicities, e.g., sarcoidosis, dermatomyositis or subacute lupus, have also been reported. In this review, we summarize the aspects of ICB-induced cutaneous toxicities in patients with melanoma, emphasizing their management and treatment options in clinical practice.

摘要

在过去十年中,免疫检查点阻断剂(ICB)已被广泛用于治疗各种肿瘤,包括晚期和转移性黑色素瘤。虽然这些药物提高了黑色素瘤患者的生存率,但它们也与各种自身免疫毒性相关,其中皮肤最常受到影响。皮肤毒性的严重程度不仅会对患者的生活质量产生负面影响,还会限制癌症的适当治疗。因此,皮肤科医生在早期发现和及时治疗这些不良事件方面发挥着重要作用。斑丘疹、银屑病样、苔藓样皮肤病和大疱性类天疱疮是最常见的需要立即干预的皮肤不良事件。其他罕见的自身免疫毒性,如结节病、皮肌炎或亚急性狼疮也有报道。在这篇综述中,我们总结了黑色素瘤患者中ICB诱导的皮肤毒性的各个方面,强调了它们在临床实践中的管理和治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd25/10093334/ea1c8f3efccf/cancers-15-02084-g001.jpg

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