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The Use of Biologic Agents for the Treatment of Cutaneous Immune-Related Adverse Events from Immune Checkpoint Inhibitors: A Review of Reported Cases

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Abstract

Cutaneous immune-related adverse events encompass a spectrum of dermatological manifestations, including lichenoid reactions, psoriasiform eruptions, eczematous dermatitis, immunobullous disorders, granulomatous reactions, pruritus, vitiligo, and severe cutaneous adverse reactions such as Stevens–Johnson syndrome. The conventional approach to treating high-grade or refractory cutaneous immune-related adverse events has involved high-dose systemic corticosteroids. However, their use is limited owing to the potential disruption of antitumor responses and associated complications. To address this, corticosteroid-sparing targeted immunomodulators have been explored as therapeutic alternatives. Biologic agents, commonly employed for non-cutaneous immune-related adverse events such as colitis, are increasingly recognized for their efficacy in treating various patterns of cutaneous immune-related adverse events, including psoriasiform, immunobullous, and Stevens–Johnson syndrome-like reactions. This review consolidates findings from the English-language literature, highlighting the use of biologic agents in managing diverse cutaneous immune-related adverse event patterns, also encompassing maculopapular, eczematous, and lichenoid eruptions, pruritus, and transient acantholytic dermatosis (Grover disease). Despite the established efficacy of these agents, further research is necessary to explore their long-term effects on antitumor responses.

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Authors and Affiliations

  1. Yale University School of Medicine, New Haven, CT, USA

    Jolanta Pach, Kailyn Valido & Annika Belzer

  2. Department of Dermatology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA

    Jonathan S. Leventhal

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  1. Jolanta Pach
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  2. Kailyn Valido
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Correspondence to Jonathan S. Leventhal.

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Jolanta Pach, Kailyn Valido, Annika Belzer, and Jonathan S. Leventhal have no conflicts of interest that are directly relevant to the content of this article. Jonathan S. Leventhal serves on the advisory boards of La Roche-Posay and Sanofi and Regeneron Pharmaceuticals and receives clinical trial funding from Azitra, Inc. and OnQuality.

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All authors contributed to the study conception and design. Material preparation and the literature review were performed by JP, KV, and AB. The first draft of the manuscript was written by JP, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Pach, J., Valido, K., Belzer, A. et al. The Use of Biologic Agents for the Treatment of Cutaneous Immune-Related Adverse Events from Immune Checkpoint Inhibitors: A Review of Reported Cases. Am J Clin Dermatol (2024). https://doi.org/10.1007/s40257-024-00866-z

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