Clinical and pathological characterization of Tebentafusp-associated skin toxicity - a cohort study with 33 patients.
drug-associated rash
exanthema
gp100
rash
tebentafusp
uveal melanoma
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
29 Aug 2024
29 Aug 2024
Historique:
received:
27
05
2024
revised:
29
07
2024
accepted:
14
08
2024
medline:
1
9
2024
pubmed:
1
9
2024
entrez:
31
8
2024
Statut:
aheadofprint
Résumé
Tebentafusp is a novel treatment for patients with metastatic uveal melanoma and often causes cutaneous side effects. The aim of this study was to better characterize these heterogenous cutaneous side effects. This prospective cohort study evaluated all patients from a tertiary hospital center who were treated with tebentafusp between January 2019 and June 2023 clinically and assessed skin biopsies histologically. In total, 33 patients were analysed. Skin toxicity was observed in 78.8% of patients and was classified in five clinical categories: 1) symmetrical erythematous patches (83.8%), 2) hemorrhagic macules (11.8%), 3) urticarial lesions (7.4%), 4) bullous lesions (1.5%) and 5) skin (8.5%) and hair depigmentation (11.4%). Histopathologic features were focal lymphocytic interface dermatitis with epidermal infiltration of CD8-positive lymphocytes. Patients with skin reactions had a significantly longer median overall survival compared to patients without any cutaneous events (34 versus 4 months, p<0.001). Monocentric study with a limited number of patients. Tebentafusp frequently induced cutaneous reactions. Pathogenesis is likely due to binding of tebentafusp to stimulated melanocytes in the skin followed by infiltration and activation of lymphocytes. Development of treatment induced skin reactions may be associated with survival benefit.
Sections du résumé
BACKGROUND
BACKGROUND
Tebentafusp is a novel treatment for patients with metastatic uveal melanoma and often causes cutaneous side effects.
OBJECTIVES
OBJECTIVE
The aim of this study was to better characterize these heterogenous cutaneous side effects.
METHODS
METHODS
This prospective cohort study evaluated all patients from a tertiary hospital center who were treated with tebentafusp between January 2019 and June 2023 clinically and assessed skin biopsies histologically.
RESULTS
RESULTS
In total, 33 patients were analysed. Skin toxicity was observed in 78.8% of patients and was classified in five clinical categories: 1) symmetrical erythematous patches (83.8%), 2) hemorrhagic macules (11.8%), 3) urticarial lesions (7.4%), 4) bullous lesions (1.5%) and 5) skin (8.5%) and hair depigmentation (11.4%). Histopathologic features were focal lymphocytic interface dermatitis with epidermal infiltration of CD8-positive lymphocytes. Patients with skin reactions had a significantly longer median overall survival compared to patients without any cutaneous events (34 versus 4 months, p<0.001).
LIMITATION
CONCLUSIONS
Monocentric study with a limited number of patients.
CONCLUSION
CONCLUSIONS
Tebentafusp frequently induced cutaneous reactions. Pathogenesis is likely due to binding of tebentafusp to stimulated melanocytes in the skin followed by infiltration and activation of lymphocytes. Development of treatment induced skin reactions may be associated with survival benefit.
Identifiants
pubmed: 39216820
pii: S0190-9622(24)02741-5
doi: 10.1016/j.jaad.2024.08.037
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Published by Elsevier Inc.