Koumprentziotis Ioannis-Alexios, Niforou Aikaterini, Tsimpidakis Antonios, Nikolaou Christos, Stratigos Alexander, Nikolaou Vasiliki
First Department of Dermatology, "Andreas Sygros" Hospital for Skin Diseases, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Int J Dermatol. 2025 Oct;64(10):1825-1832. doi: 10.1111/ijd.17850. Epub 2025 May 15.
The emergence of immune checkpoint inhibitors has revolutionized the landscape of cancer treatment in the modern era. However, cutaneous immune-related adverse events (cirAEs) are common, significantly affecting patients' quality of life and often leading to treatment discontinuation, which may compromise oncological outcomes. Dupilumab, an immunoglobulin G4 (IgG4) human monoclonal antibody targeting interleukin (IL)-4 and IL-13 receptors, is widely used for dermatologic conditions but remains unapproved for cirAEs due to the limited and scattered supporting evidence. This review aimed to summarize the available evidence regarding the use of dupilumab for the management of cirAEs. A systematic review was conducted using MEDLINE/PubMed, Scopus, and Web of Science in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In total, 25 publications met the eligibility criteria and were included, reporting 136 patients who were diagnosed with 140 cirAEs and were treated with dupilumab. The most frequently treated cirAEs were eczematous rashes, bullous pemphigoid, and maculopapular/morbilliform rashes. Dupilumab was found to be highly effective, with most patients achieving complete or partial responses, even when affected by two concomitant cirAEs. An acceptable safety profile was demonstrated regarding both adverse events and oncological safety, with no additional concerns to be raised. The findings may be encouraging but are limited by the relatively small number of patients treated and the nature of the included studies, with most of them being case reports and case series. More research is warranted, along with more clinical studies, prospective in design, focused on relevant clinical outcomes of this dupilumab-treated subset of patients.
免疫检查点抑制剂的出现彻底改变了现代癌症治疗的格局。然而，皮肤免疫相关不良事件（cirAEs）很常见，严重影响患者的生活质量，并常常导致治疗中断，这可能会影响肿瘤治疗效果。度普利尤单抗是一种靶向白细胞介素（IL）-4和IL-13受体的免疫球蛋白G4（IgG4）人源单克隆抗体，广泛用于皮肤病治疗，但由于支持证据有限且分散，其在cirAEs治疗方面尚未获批。本综述旨在总结关于度普利尤单抗用于治疗cirAEs的现有证据。按照系统评价和Meta分析的首选报告项目（PRISMA）指南，使用MEDLINE/PubMed、Scopus和Web of Science进行了系统评价。总共25篇出版物符合纳入标准并被纳入，报告了136例被诊断患有140例cirAEs并接受度普利尤单抗治疗的患者。最常治疗的cirAEs是湿疹样皮疹、大疱性类天疱疮和斑丘疹/麻疹样皮疹。发现度普利尤单抗非常有效，大多数患者即使同时受到两种cirAEs影响也能实现完全或部分缓解。在不良事件和肿瘤安全性方面均显示出可接受的安全性，没有其他问题。这些发现可能令人鼓舞，但受到治疗患者数量相对较少以及纳入研究性质的限制，其中大多数是病例报告和病例系列。需要进行更多研究，以及更多设计前瞻性的临床研究，关注接受度普利尤单抗治疗的这部分患者的相关临床结局。
