Zenderowski Veronika, Hutchinson James A, Brosig Andreas, Haferkamp Sebastian, Kronenberg Katharina
Department of Dermatology, University Hospital Regensburg, Regensburg, Germany.
Department of Surgery, University Hospital Regensburg, Regensburg, Germany.
Skin Health Dis. 2025 Jun 25;5(4):293-296. doi: 10.1093/skinhd/vzaf045. eCollection 2025 Aug.
Immune-related adverse events (irAE) are common in checkpoint blockade-treated patients and limit its clinical application. Corticosteroids are the first-line therapy for treatment of irAE, but animal models clearly demonstrate that steroids diminish anti-programmed cell death protein 1 (PD-1)-induced tumour immunity. Better strategies to manage irAE while preserving anti-tumour immunity are needed. Extracorporeal photopheresis (ECP) was recently introduced as second-line treatment for steroid-refractory immune checkpoint inhibitor (ICI)-related colitis and hepatitis. Here, we extend the application of ECP to immune-related maculopapular rash after adjuvant anti-PD-1 therapy in a single melanoma patient. The patient's dermatitis markedly improved after off-label ECP, with a substantial reduction in skin lesions and pruritus scores, and stabilization of immune markers. The patient remained well after ECP with no recurrent or metastatic disease at 14 months after starting ECP treatment. Hence, in this case, ECP led to successful resolution of pembrolizumab-induced dermatitis and a favourable oncological outcome.
免疫相关不良事件（irAE）在接受检查点阻断治疗的患者中很常见，限制了其临床应用。皮质类固醇是治疗irAE的一线疗法，但动物模型清楚地表明，类固醇会削弱抗程序性细胞死亡蛋白1（PD-1）诱导的肿瘤免疫。需要更好的策略来管理irAE，同时保留抗肿瘤免疫力。体外光化学疗法（ECP）最近被引入作为类固醇难治性免疫检查点抑制剂（ICI）相关结肠炎和肝炎的二线治疗方法。在此，我们将ECP的应用扩展到一名黑色素瘤患者在辅助抗PD-1治疗后出现的免疫相关斑丘疹皮疹。在进行超说明书使用的ECP治疗后，患者的皮炎明显改善，皮肤病变和瘙痒评分大幅降低，免疫标志物稳定。在开始ECP治疗14个月后，患者在接受ECP治疗后情况良好，没有复发或转移性疾病。因此，在这种情况下，ECP成功解决了帕博利珠单抗引起的皮炎，并带来了良好的肿瘤学结果。
