Importance: An increasing number of cutaneous adverse reactions resulting from use of programmed cell death protein 1 (PD-1) inhibitors have been described, but with relatively little focus to date on the timing of these reactions. Objective: To determine the timing of cutaneous drug reactions after initiation of PD-1 inhibitor therapy. Design, Setting, and Participants: This retrospective observational study included patients referred to an academic dermatology clinic by an oncologist from January 1, 2014, through February 28, 2018, with at least 1 skin biopsy specimen of a skin reaction associated with PD-1 inhibitor use. Participants were included if they had a biopsy-proven cutaneous reaction in response to a PD-1 inhibitor used alone or in combination with ipilimumab. Exposures: All patients included in this study received pembrolizumab, nivolumab, or nivolumab with ipilimumab as immunotherapy for cancer. Main Outcomes and Measures: The main outcome measure was time to onset of biopsy-proven cutaneous reactions that occurred during or after use of pembrolizumab or nivolumab. Results: A total of 17 patients (12 men, 5 women; mean [SD] age, 68.6 [11.1] years) were identified who presented with cutaneous adverse reactions associated with PD-1 inhibitor therapy; these reactions included lichenoid dermatitis, bullous pemphigoid, erythema multiforme, eczema, lupus, and sarcoidosis. Twelve patients presented with reactions at least 3 months after beginning pembrolizumab or nivolumab therapy. The skin reactions presented a median (range) of 4.2 months (0.5-38.0 months) after drug initiation. In 5 cases, the cutaneous adverse reactions attributed to the PD-1 inhibitor therapy developed after the drug therapy was terminated. Conclusions and Relevance: Diverse cutaneous adverse reactions secondary to PD-1 inhibitor use may present with delayed onsets and even after discontinuation of therapy. Dermatologists should be aware of the potential for delayed presentations of cutaneous adverse reactions.
Importance: An increasing number of cutaneous adverse reactions resulting from use of programmed cell death protein 1 (PD-1) inhibitors have been described, but with relatively little focus to date on the timing of these reactions. Objective: To determine the timing of cutaneous drug reactions after initiation of PD-1 inhibitor therapy. Design, Setting, and Participants: This retrospective observational study included patients referred to an academic dermatology clinic by an oncologist from January 1, 2014, through February 28, 2018, with at least 1 skin biopsy specimen of a skin reaction associated with PD-1 inhibitor use. Participants were included if they had a biopsy-proven cutaneous reaction in response to a PD-1 inhibitor used alone or in combination with ipilimumab. Exposures: All patients included in this study received pembrolizumab, nivolumab, or nivolumab with ipilimumab as immunotherapy for cancer. Main Outcomes and Measures: The main outcome measure was time to onset of biopsy-proven cutaneous reactions that occurred during or after use of pembrolizumab or nivolumab. Results: A total of 17 patients (12 men, 5 women; mean [SD] age, 68.6 [11.1] years) were identified who presented with cutaneous adverse reactions associated with PD-1 inhibitor therapy; these reactions included lichenoid dermatitis, bullous pemphigoid, erythema multiforme, eczema, lupus, and sarcoidosis. Twelve patients presented with reactions at least 3 months after beginning pembrolizumab or nivolumab therapy. The skin reactions presented a median (range) of 4.2 months (0.5-38.0 months) after drug initiation. In 5 cases, the cutaneous adverse reactions attributed to the PD-1 inhibitor therapy developed after the drug therapy was terminated. Conclusions and Relevance: Diverse cutaneous adverse reactions secondary to PD-1 inhibitor use may present with delayed onsets and even after discontinuation of therapy. Dermatologists should be aware of the potential for delayed presentations of cutaneous adverse reactions.
Authors: Jeffrey S Weber; F Stephen Hodi; Jedd D Wolchok; Suzanne L Topalian; Dirk Schadendorf; James Larkin; Mario Sznol; Georgina V Long; Hewei Li; Ian M Waxman; Joel Jiang; Caroline Robert Journal: J Clin Oncol Date: 2016-11-14 Impact factor: 44.544
Authors: Mark C Mochel; Michael E Ming; Sotonye Imadojemu; Tara C Gangadhar; Lynn M Schuchter; Rosalie Elenitsas; Aimee S Payne; Emily Y Chu Journal: J Cutan Pathol Date: 2016-06-01 Impact factor: 1.587
Authors: Dirk Schadendorf; Jedd D Wolchok; F Stephen Hodi; Vanna Chiarion-Sileni; Rene Gonzalez; Piotr Rutkowski; Jean-Jacques Grob; C Lance Cowey; Christopher D Lao; Jason Chesney; Caroline Robert; Kenneth Grossmann; David McDermott; Dana Walker; Rafia Bhore; James Larkin; Michael A Postow Journal: J Clin Oncol Date: 2017-08-25 Impact factor: 44.544
Authors: Jonathan L Curry; Michael T Tetzlaff; Priyadharsini Nagarajan; Carol Drucker; Adi Diab; Sharon R Hymes; Madeleine Duvic; Wen-Jen Hwu; Jennifer A Wargo; Carlos A Torres-Cabala; Ronald P Rapini; Victor G Prieto Journal: J Cutan Pathol Date: 2016-12-21 Impact factor: 1.587
Authors: Caroline Robert; Antoni Ribas; Omid Hamid; Adil Daud; Jedd D Wolchok; Anthony M Joshua; Wen-Jen Hwu; Jeffrey S Weber; Tara C Gangadhar; Richard W Joseph; Roxana Dronca; Amita Patnaik; Hassane Zarour; Richard Kefford; Peter Hersey; Jin Zhang; James Anderson; Scott J Diede; Scot Ebbinghaus; F Stephen Hodi Journal: J Clin Oncol Date: 2017-12-28 Impact factor: 44.544
Authors: Abdul Rafeh Naqash; Ebenezer Appah; Li V Yang; Mahvish Muzaffar; Mona A Marie; Justin D Mccallen; Shravanti Macherla; Darla Liles; Paul R Walker Journal: J Immunother Cancer Date: 2019-07-05 Impact factor: 13.751
Authors: Marcus A Couey; R Bryan Bell; Ashish A Patel; Meghan C Romba; Marka R Crittenden; Brendan D Curti; Walter J Urba; Rom S Leidner Journal: J Immunother Cancer Date: 2019-07-03 Impact factor: 13.751