Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting PD-1 and PD-L1

Jarushka Naidoo, Katja Schindler, Christiane Querfeld, Klaus Busam, Jane Cunningham, David B. Page, Michael A. Postow, Alyona Weinstein, Anna Skripnik Lucas, Kathryn T. Ciccolini, Elizabeth A. Quigley, Alexander M. Lesokhin, Paul K. Paik, Jamie E. Chaft, Neil H. Segal, Sandra P. D'Angelo, Mark A. Dickson, Jedd D. Wolchok, Mario E. Lacouture

Research output: Contribution to journalArticle

Abstract

Monoclonal antibodies (mAb) targeting immune checkpoint pathways such as cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed death 1 (PD-1) may confer durable disease control in several malignancies. In some patients, immune checkpoint mAbs cause cutaneous immune-related adverse events. Although the most commonly reported cutaneous toxicities are mild, a subset may persist despite therapy and can lead to severe or life-threatening toxicity. Autoimmune blistering disorders are not commonly associated with immune checkpoint mAb therapy. We report a case series of patients who developed bullous pemphigoid (BP), an autoimmune process classically attributed to pathologic autoantibody formation and complement deposition. Three patients were identified. Two patients developed BP while receiving the anti-PD-1 mAb nivolumab, and one while receiving the anti-PD-L1 mAb durvalumab. The clinicopathologic features of each patient and rash, and corresponding radiologic findings at the development of the rash and after its treatment, are described. Patients receiving an anti-PD-1/PD-L1 mAb may develop immune-related BP. This may be related to both T-cell- and B-cell-mediated responses. Referral to a dermatologist for accurate diagnosis and management is recommended.

Original languageEnglish (US)
Pages (from-to)383-390
Number of pages8
JournalCancer immunology research
Volume4
Issue number5
DOIs
StatePublished - May 1 2016

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Immune System Diseases
Bullous Pemphigoid
Skin
Monoclonal Antibodies
Exanthema
Cytotoxic T-Lymphocytes
Autoantibodies
B-Lymphocytes
Therapeutics
Referral and Consultation
T-Lymphocytes
Neoplasms
Proteins

ASJC Scopus subject areas

  • Cancer Research
  • Immunology

Cite this

Naidoo, J., Schindler, K., Querfeld, C., Busam, K., Cunningham, J., Page, D. B., ... Lacouture, M. E. (2016). Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting PD-1 and PD-L1. Cancer immunology research, 4(5), 383-390. https://doi.org/10.1158/2326-6066.CIR-15-0123

Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting PD-1 and PD-L1. / Naidoo, Jarushka; Schindler, Katja; Querfeld, Christiane; Busam, Klaus; Cunningham, Jane; Page, David B.; Postow, Michael A.; Weinstein, Alyona; Lucas, Anna Skripnik; Ciccolini, Kathryn T.; Quigley, Elizabeth A.; Lesokhin, Alexander M.; Paik, Paul K.; Chaft, Jamie E.; Segal, Neil H.; D'Angelo, Sandra P.; Dickson, Mark A.; Wolchok, Jedd D.; Lacouture, Mario E.

In: Cancer immunology research, Vol. 4, No. 5, 01.05.2016, p. 383-390.

Research output: Contribution to journalArticle

Naidoo, J, Schindler, K, Querfeld, C, Busam, K, Cunningham, J, Page, DB, Postow, MA, Weinstein, A, Lucas, AS, Ciccolini, KT, Quigley, EA, Lesokhin, AM, Paik, PK, Chaft, JE, Segal, NH, D'Angelo, SP, Dickson, MA, Wolchok, JD & Lacouture, ME 2016, 'Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting PD-1 and PD-L1', Cancer immunology research, vol. 4, no. 5, pp. 383-390. https://doi.org/10.1158/2326-6066.CIR-15-0123
Naidoo, Jarushka ; Schindler, Katja ; Querfeld, Christiane ; Busam, Klaus ; Cunningham, Jane ; Page, David B. ; Postow, Michael A. ; Weinstein, Alyona ; Lucas, Anna Skripnik ; Ciccolini, Kathryn T. ; Quigley, Elizabeth A. ; Lesokhin, Alexander M. ; Paik, Paul K. ; Chaft, Jamie E. ; Segal, Neil H. ; D'Angelo, Sandra P. ; Dickson, Mark A. ; Wolchok, Jedd D. ; Lacouture, Mario E. / Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting PD-1 and PD-L1. In: Cancer immunology research. 2016 ; Vol. 4, No. 5. pp. 383-390.
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