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Anogenital lichen sclerosus et atrophicus lesions in a case series of cancer patients on immunotherapy

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Abstract

Lichenoid reactions are one of the most frequently observed toxicities with anticancer agents and, recently, a rapid emergence of immunotherapies in oncology has hastened the need to better characterize their unique toxicity profiles, particularly for less common skin toxicities, including anogenital lichen sclerosus et atrophicus (LSA). This case series describes four patients with advanced cancer (one melanoma, two lung cancers, and one kidney tumor) developing LSA lesions while receiving an immunotherapy. Medical records from 2017 to 2020 were retrospectively reviewed. Two patients received pembrolizumab, anti-programmed cell death-1 (PD-1), one nivolumab, anti-programmed cell death-1 (PD-1), and one ipilimumab, an immune checkpoint inhibitor. LSA emerged after a median of 3 months (range, 2–4 months) from starting immunotherapy. All LSA cases were grade 2. Three cases occurred on the penis and one case on the anus. All patients improved after a specific treatment for LSA, and no LSA-related antineoplastic treatment interruption/life-threatening condition were reported. To date, this is the first case series of LSA lesions associated with immunotherapy. Early LSA recognition and management is helpful in cancer patients on immunotherapy allowing a long survival and treatment response.

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Abbreviations

IT:

Immunotherapy

LSA:

Lichen Sclerosus et Atrophicus

M:

Male

mo:

Months

N:

Number

OS:

Overall survival

PFS:

Progression-free survival

pt:

Patient

yrs:

Years

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Acknowledgements

Patients and their families.

Funding

No funding was required in the preparation of this manuscript.

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Author notes

  1. Conteduca V, Medri M are contributed equally.

Authors and Affiliations

  1. Department of Medical Oncology, IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori (IRST) “Dino Amadori”, via Piero Maroncelli 40, 47014, Meldola, Italy

    V. Conteduca & U. De Giorgi

  2. Department of Medical and Surgical Sciences, Unit of Medical Oncology and Biomolecular Therapy, University of Foggia, Policlinico Riuniti, 71122, Foggia, Italy

    V. Conteduca

  3. Skin Cancer Unit, IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori (IRST) “Dino Amadori”, Meldola, Italy

    M. Medri, L. Mazzoni & I. Stanganelli

  4. Department of Dermatology, University of Parma, Parma, Italy

    I. Stanganelli

Authors
  1. V. Conteduca
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  2. M. Medri
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  3. L. Mazzoni
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  4. U. De Giorgi
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  5. I. Stanganelli
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Contributions

Study concept and design: Conteduca, Medri. Acquisition, analysis, or interpretation of data: Conteduca, Medri, Mazzoni, De Giorgi, Stanganelli. Drafting of the manuscript: Conteduca, Medri. Study supervision: Stanganelli. Manuscript review and approval: all authors.

Corresponding author

Correspondence to V. Conteduca.

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Conflict of interest

V. Conteduca received speaker honoraria or travel support from Astellas, Janssen-Cilag, and Sanofi-Aventis. V. Conteduca received consulting fee from Bayer and is an advisory board member of Janssen, Astellas, AstraZeneca, and Merck. U. De Giorgi reports grants from AstraZeneca; personal fees from Astellas, Bayer, Novartis, Merck Sharp & Dohme, and Pharmamar; grants and personal fees from Sanofi; grants and non-financial support from Roche; and personal fees and non-financial support from Janssen-Cilag, Pfizer, Bristol Myers Squibb, and Ipsen. No potential conflicts of interest were disclosed by the other authors.

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Conteduca, V., Medri, M., Mazzoni, L. et al. Anogenital lichen sclerosus et atrophicus lesions in a case series of cancer patients on immunotherapy. Cancer Immunol Immunother 71, 1545–1548 (2022). https://doi.org/10.1007/s00262-021-03094-0

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  • DOI: https://doi.org/10.1007/s00262-021-03094-0

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