Prevalence of dermatological toxicities in patients with melanoma undergoing immunotherapy: Systematic review and meta-analysis.
Antibodies, Monoclonal, Humanized
/ adverse effects
Clinical Trials as Topic
Exanthema
/ epidemiology
Female
Humans
Immune Checkpoint Inhibitors
/ adverse effects
Immunotherapy
/ adverse effects
Ipilimumab
/ adverse effects
Male
Melanoma
/ therapy
Middle Aged
Nivolumab
/ adverse effects
Observational Studies as Topic
Prevalence
Pruritus
/ epidemiology
Skin Neoplasms
/ therapy
Vitiligo
/ epidemiology
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
24
07
2019
accepted:
22
07
2021
entrez:
6
8
2021
pubmed:
7
8
2021
medline:
15
12
2021
Statut:
epublish
Résumé
Checkpoint inhibitors have revolutionized advanced melanoma care; however, their cutaneous side effects have not been definitively elucidated. To identify the prevalence of cutaneous toxicity in patients with melanoma treated with immune checkpoint inhibitors as monotherapy and/or in combination with chemotherapy and/or radiotherapy. We performed a systematic review and meta-analysis, which encompassed both clinical trials and observational studies describing the dermatological toxicities in patients treated with immune checkpoint inhibitors. The protocol was registered in the International Prospective Register of Systematic Review under the number CRD42018091915. The searches were performed using the CINAHL, Cochrane CENTRAL, LILACS, LIVIVO, PubMed, Scopus, and Web of Science databases. The methodological quality of the studies was evaluated with the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data. A total of 9,802 articles were identified in the databases. The final sample comprised 39 studies. The evaluated drugs were ipilimumab, tremelimumab, pembrolizumab, and nivolumab. The results suggest that the most prevalent side effect was grade 1 and 2 pruritus (24%), followed by grade 1 and 2 rash (21%) and grade 1 and 2 vitiligo (10%). The most prevalent side effects in patients treated with checkpoint inhibitors are pruritus, rash, and vitiligo, and they are rated mostly as grades 1 and 2 adverse events. Remarkably, vitiligo is most commonly found in patients treated with PD-1 inhibitors.
Sections du résumé
BACKGROUND
Checkpoint inhibitors have revolutionized advanced melanoma care; however, their cutaneous side effects have not been definitively elucidated.
OBJECTIVE
To identify the prevalence of cutaneous toxicity in patients with melanoma treated with immune checkpoint inhibitors as monotherapy and/or in combination with chemotherapy and/or radiotherapy.
MATERIALS AND METHODS
We performed a systematic review and meta-analysis, which encompassed both clinical trials and observational studies describing the dermatological toxicities in patients treated with immune checkpoint inhibitors. The protocol was registered in the International Prospective Register of Systematic Review under the number CRD42018091915. The searches were performed using the CINAHL, Cochrane CENTRAL, LILACS, LIVIVO, PubMed, Scopus, and Web of Science databases. The methodological quality of the studies was evaluated with the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data.
RESULTS
A total of 9,802 articles were identified in the databases. The final sample comprised 39 studies. The evaluated drugs were ipilimumab, tremelimumab, pembrolizumab, and nivolumab. The results suggest that the most prevalent side effect was grade 1 and 2 pruritus (24%), followed by grade 1 and 2 rash (21%) and grade 1 and 2 vitiligo (10%).
CONCLUSION
The most prevalent side effects in patients treated with checkpoint inhibitors are pruritus, rash, and vitiligo, and they are rated mostly as grades 1 and 2 adverse events. Remarkably, vitiligo is most commonly found in patients treated with PD-1 inhibitors.
Identifiants
pubmed: 34358260
doi: 10.1371/journal.pone.0255716
pii: PONE-D-19-20870
pmc: PMC8345892
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
Immune Checkpoint Inhibitors
0
Ipilimumab
0
Nivolumab
31YO63LBSN
pembrolizumab
DPT0O3T46P
tremelimumab
QEN1X95CIX
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0255716Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Adv Exp Med Biol. 2017;995:155-174
pubmed: 28321817
Melanoma Manag. 2015 Aug;2(3):267-284
pubmed: 30190854
Lancet Oncol. 2012 May;13(5):459-65
pubmed: 22456429
Clin Cancer Res. 2016 Feb 15;22(4):886-94
pubmed: 26446948
Scientifica (Cairo). 2018 Dec 30;2018:5036213
pubmed: 30693134
Front Immunol. 2020 Nov 06;11:579022
pubmed: 33240267
Expert Rev Clin Immunol. 2017 Oct;13(10):1001-1015
pubmed: 28795649
JAMA Dermatol. 2016 Jan;152(1):45-51
pubmed: 26501224
Am Health Drug Benefits. 2018 Oct;11(7):334-343
pubmed: 30647822
Diagnostics (Basel). 2018 Oct 31;8(4):
pubmed: 30384507
Expert Opin Biol Ther. 2016;16(3):389-96
pubmed: 26750801
Oncologist. 2016 Oct;21(10):1230-1240
pubmed: 27401894
Ann Oncol. 2016 Jul;27(7):1362
pubmed: 27072927
J Clin Oncol. 2013 Feb 10;31(5):616-22
pubmed: 23295794
Curr Probl Dermatol. 2018;53:82-92
pubmed: 29131040
J Exp Clin Cancer Res. 2013 Oct 25;32:82
pubmed: 24423086
BMJ. 2018 Nov 8;363:k4226
pubmed: 30409774
Lancet Oncol. 2017 Sep;18(9):1202-1210
pubmed: 28729151
Cancer. 2017 Jun 1;123(S11):2143-2153
pubmed: 28543699
J Clin Oncol. 2008 Dec 20;26(36):5950-6
pubmed: 19018089
Am Soc Clin Oncol Educ Book. 2019 Jan;39:564-571
pubmed: 31099689
Clin J Oncol Nurs. 2017 Apr 1;21(2 Suppl):45-52
pubmed: 28315555
Onco Targets Ther. 2017 Jun 16;10:3007-3015
pubmed: 28670133
Eur J Cancer. 2018 Dec;105:114-126
pubmed: 30447539
Curr Probl Cancer. 2017 Mar - Apr;41(2):125-128
pubmed: 28190531
J Cutan Pathol. 2017 Feb;44(2):158-176
pubmed: 27859479
N Engl J Med. 2015 Jan 22;372(4):320-30
pubmed: 25399552
Hematol Oncol Clin North Am. 2019 Apr;33(2):275-290
pubmed: 30833000
Memo. 2018;11(2):132-137
pubmed: 29983828
J Clin Oncol. 2018 Feb 1;36(4):383-390
pubmed: 28671856
Ann Dermatol Venereol. 2018 May;145(5):313-330
pubmed: 29678394
Eur J Cancer. 2016 Feb;54:139-148
pubmed: 26765102
JAMA Oncol. 2017 Nov 1;3(11):1511-1519
pubmed: 28662232
Case Rep Dermatol. 2018 Jan 18;10(1):1-6
pubmed: 29515387
N Engl J Med. 2017 Nov 9;377(19):1824-1835
pubmed: 28891423
Cancer Immunol Immunother. 2017 Sep;66(9):1153-1162
pubmed: 28444424
Lancet Oncol. 2016 Nov;17(11):1558-1568
pubmed: 27622997
Cancer. 2010 Apr 1;116(7):1767-75
pubmed: 20143434
N Engl J Med. 2016 Nov 10;375(19):1845-1855
pubmed: 27717298
J Transl Med. 2015 Nov 06;13:351
pubmed: 26541511
Am Soc Clin Oncol Educ Book. 2015;:76-83
pubmed: 25993145
Am J Clin Dermatol. 2018 Jun;19(3):345-361
pubmed: 29256113
Cancer Sci. 2017 Jun;108(6):1223-1230
pubmed: 28342215
Lancet Oncol. 2015 Aug;16(8):908-18
pubmed: 26115796
N Engl J Med. 2015 May 21;372(21):2006-17
pubmed: 25891304
Lancet Oncol. 2017 May;18(5):611-622
pubmed: 28359784
N Engl J Med. 2018 May 10;378(19):1789-1801
pubmed: 29658430
Ann Oncol. 2015 Sep;26(9):1824-1829
pubmed: 25888611
Cancer Res Treat. 2017 Jan;49(1):44-53
pubmed: 27121719
Int J Evid Based Healthc. 2018 Dec;16(4):195-203
pubmed: 29621038
Eur J Dermatol. 2017 Jun 1;27(3):266-270
pubmed: 28524050
Oncologist. 2013 Jun;18(6):726-32
pubmed: 23716015
Med J Aust. 2016 Nov 7;205(9):418-424
pubmed: 27809739
Cancer Chemother Pharmacol. 2017 Apr;79(4):651-660
pubmed: 28283736
J Natl Compr Canc Netw. 2015 May;13(5 Suppl):686-9
pubmed: 25995431
PLoS One. 2013;8(1):e53745
pubmed: 23341990
N Engl J Med. 2018 Jan 11;378(2):158-168
pubmed: 29320654
PLoS One. 2015 Mar 11;10(3):e0118564
pubmed: 25761109
Future Oncol. 2015;11(17):2471-84
pubmed: 26274495
Front Pharmacol. 2017 Oct 18;8:730
pubmed: 29093678
Clin Transl Oncol. 2019 May;21(5):556-571
pubmed: 30284232
N Engl J Med. 2013 Jul 11;369(2):122-33
pubmed: 23724867
Dermatol Online J. 2017 Sep 15;23(9):
pubmed: 29469720
Cancer Immun. 2013 May 01;13:7
pubmed: 23833564
Cancer Chemother Pharmacol. 2015 Nov;76(5):997-1004
pubmed: 26410424
N Engl J Med. 2011 Jun 30;364(26):2517-26
pubmed: 21639810
J Cell Physiol. 2019 Jun;234(6):8541-8549
pubmed: 30511409
J Dermatol. 2017 Feb;44(2):117-122
pubmed: 27510892
Nat Rev Cancer. 2012 Mar 22;12(4):252-64
pubmed: 22437870
Curr Opin Oncol. 2016 Jul;28(4):254-63
pubmed: 27136138
N Engl J Med. 2015 Jun 25;372(26):2521-32
pubmed: 25891173
JAMA Oncol. 2018 Jan 1;4(1):98-101
pubmed: 28817755
Cancer Sci. 2017 May;108(5):1022-1031
pubmed: 28266140
Ann Oncol. 2017 Oct 1;28(10):2377-2385
pubmed: 28945858
N Engl J Med. 2013 Jul 11;369(2):134-44
pubmed: 23724846
Clin Cancer Res. 2013 Oct 1;19(19):5300-9
pubmed: 24089443
J Clin Oncol. 2009 Mar 1;27(7):1075-81
pubmed: 19139427
Int J Surg. 2010;8(5):336-41
pubmed: 20171303