TY - JOUR
T1 - Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting PD-1 and PD-L1
AU - Naidoo, Jarushka
AU - Schindler, Katja
AU - Querfeld, Christiane
AU - Busam, Klaus
AU - Cunningham, Jane
AU - Page, David B.
AU - Postow, Michael A.
AU - Weinstein, Alyona
AU - Lucas, Anna Skripnik
AU - Ciccolini, Kathryn T.
AU - Quigley, Elizabeth A.
AU - Lesokhin, Alexander M.
AU - Paik, Paul K.
AU - Chaft, Jamie E.
AU - Segal, Neil H.
AU - D'Angelo, Sandra P.
AU - Dickson, Mark A.
AU - Wolchok, Jedd D.
AU - Lacouture, Mario E.
N1 - Publisher Copyright:
©2016 American Association for Cancer Research.
PY - 2016/5
Y1 - 2016/5
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84976354836&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84976354836&partnerID=8YFLogxK
U2 - 10.1158/2326-6066.CIR-15-0123
DO - 10.1158/2326-6066.CIR-15-0123
M3 - Article
C2 - 26928461
AN - SCOPUS:84976354836
SN - 2326-6066
VL - 4
SP - 383
EP - 390
JO - Cancer Immunology Research
JF - Cancer Immunology Research
IS - 5
ER -