Kraehenbuehl Lukas, Schneider Stephanie, Pawlik Laura, Mangana Joanna, Cheng Phil, Dummer Reinhard, Meier-Schiesser Barbara
Department of Dermatology, University Hospital Zurich (USZ), University of Zurich (UZH), 8091 Zurich, Switzerland.
Pharmaceuticals (Basel). 2023 Jun 27;16(7):935. doi: 10.3390/ph16070935.
Recent progress in the treatment of advanced melanoma has led to the improved survival of affected patients. However, novel treatments also lead to considerable and distinct skin toxicity. To further characterize cutaneous adverse events (AE) of systemic treatments, we conducted a single-center retrospective study of biopsy-proven cutaneous adverse events of melanoma treatment over a period of 10 years at the University Hospital of Zurich, Switzerland. In 102 identified patients, 135 individual skin AEs developed. Immune checkpoint blockade (ICB) was causal for 81 skin AEs, and 54 were related to targeted therapies (TT). Recorded types of skin AEs included lichenoid, maculopapular, acneiform, urticarial, panniculitis, folliculitis, psoriasiform, granulomatous, eczematous, and others. The incidence of skin AEs was higher with TT (18.54%) than with ICB (9.64%, = 0.0029). Most AEs were low-grade, although 19.21% of AEs were common terminology criteria for adverse events (CTCAE) Grades 3 or 4. A large spectrum of skin AEs was documented during treatment of advanced melanoma, and distinct phenotypes were observed, depending on treatment classes. AEs occurred earlier during treatment with TT than with ICB, and distinct types of skin AEs were associated with respective treatment classes. This study comprehensively describes skin AEs occurring during systemic treatment for melanoma at a single center.
晚期黑色素瘤治疗的最新进展提高了患者的生存率。然而，新的治疗方法也会导致相当明显且独特的皮肤毒性。为了进一步明确全身治疗的皮肤不良事件（AE）特征，我们在瑞士苏黎世大学医院进行了一项单中心回顾性研究，研究了10年间经活检证实的黑色素瘤治疗皮肤不良事件。在102例确诊患者中，共出现了135例个体皮肤AE。免疫检查点阻断（ICB）导致了81例皮肤AE，54例与靶向治疗（TT）相关。记录的皮肤AE类型包括苔藓样、斑丘疹样、痤疮样、荨麻疹样、脂膜炎样、毛囊炎样、银屑病样、肉芽肿样、湿疹样等。TT导致皮肤AE的发生率（18.54%）高于ICB（9.64%，P = 0.0029）。大多数AE为低级别，尽管19.21%的AE为不良事件通用术语标准（CTCAE）3级或4级。在晚期黑色素瘤治疗期间记录了广泛的皮肤AE，且根据治疗类别观察到了不同的表型。TT治疗期间AE出现的时间早于ICB，且不同类型的皮肤AE与各自的治疗类别相关。本研究全面描述了单中心黑色素瘤全身治疗期间发生的皮肤AE。
