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Occurrences and Outcomes of Immune Checkpoint Inhibitors-Induced Vitiligo in Cancer Patients: A Retrospective Cohort Study

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Abstract

Background

The use of immune checkpoint inhibitors (ICI) in melanoma and non-small cell lung cancer patients is associated with the onset of vitiligo. However, previous studies have suggested conflicting results on the conditions of occurrence of ICI-induced vitiligo.

Objective

The aim of this study was to describe the occurrences and outcomes of several cases of ICI-induced vitiligo.

Methods

A retrospective study was carried out using the French Pharmacovigilance Database (FPD) between the beginning of the commercialization of ICI in France and 1 January 2019, selecting for analysis the vitiligo reactions of patients due to treatment with ICI.

Results

Among the 95 case patients identified in the FPD, the median times to onset of vitiligo after the start of pembrolizumab, nivolumab and ipilimumab therapies were 5.4, 5.0, and 3.8 months, respectively. Furthermore, 37 patients (45%) discontinued ICI treatment due to disease progression. The median follow-up time of all patients was 33 months (interquartile range 2–56).

Conclusions

This study provided an overall picture of ICI-induced vitiligo in daily medical practice on a large number of pharmacovigilance observations of case patients. Among the observations of ICI-induced vitiligo, the diagnosed cancer was melanoma for almost all patients. Most patients in the study experienced other associated adverse drug reactions (ADRs), such as colitis, pruritus, hypothyroidism, hyperthyroidism, thyroiditis, pancreatitis, and gastritis. Furthermore, our data suggest that the resolution of pembrolizumab- or nivolumab-induced vitiligo could be a marker of disease progression. Future studies evaluating vitiligo outcomes are warranted.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

Khaled Ezzedine contributed to the study concept and design; Bernard Begaud and Peter Pitts analyzed and interpreted the data, and critically revised the article for important intellectual content. The authors acknowledge the assistance of all 31 regional centers of the French Pharmacovigilance System.

Author information

Authors and Affiliations

  1. Department of Pharmacovigilance, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France

    Samy Babai, Célia Bertin & Hervé Le-Louet

  2. Department of Pharmacovigilance, Gustave Roussy, 94800, Villejuif, France

    Anne-Laure Voisin

  3. Department of Pharmacovigilance, INSERM, 33076, Bordeaux, France

    Amandine Gouverneur

Authors
  1. Samy Babai
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  2. Anne-Laure Voisin
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  3. Célia Bertin
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  4. Amandine Gouverneur
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  5. Hervé Le-Louet
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Corresponding author

Correspondence to Samy Babai.

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Funding

No sources of funding were used to assist in the preparation of this study.

Conflict of interest

Samy Babai, Anne-Laure Voisin, Célia Bertin, Amandine Gouverneur and Hervé Le Louet have no conflicts of interest that are directly relevant to the content of this article.

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Babai, S., Voisin, AL., Bertin, C. et al. Occurrences and Outcomes of Immune Checkpoint Inhibitors-Induced Vitiligo in Cancer Patients: A Retrospective Cohort Study. Drug Saf 43, 111–117 (2020). https://doi.org/10.1007/s40264-019-00875-6

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  • DOI: https://doi.org/10.1007/s40264-019-00875-6

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