Clinical analysis of 22 cases of cutaneous adverse reactions caused by molecular targeted antitumor agents and immune checkpoint inhibitors

Abstract

Objective To analyze cutaneous adverse reactions induced by immune checkpoint inhibitors and targeted antitumor drugs. Methods We retrospectively analyzed the clinical data of 22 cases of cutaneous adverse reactions caused by molecular targeted antitumor agents and immune checkpoint inhibitors. Results The time between the occurrence of skin adverse reactions and the first use of targeted drugs or ICIs ranged from 1 day to 4 years, with an average of 7 months. Inpatients with CTCAE grades 3 and 4 accounted for 90.91% and 9.09%, respectively. Majority of CTCAE-grade 3 patients (90.00%) mainly presented with erythema and papules, and 15.00% of patients had mucous involvement. Two CTCAE-grade 4 patients were diagnosed with drug-induced bullosa epidermolysis, accompanied by elevated inflammatory markers and abnormal liver function. The pathological findings of 8 patients with bullous pemphigoid, psoriasis or perforating collagen disease were similar to those of idiopathic diseases. All patients were discharged from hospital following the treatments with anti-allergy, anti-inflammatory and intravenous immunoglobulin therapy. Conclusions The cutaneous adverse reactions induced by immune checkpoint inhibitors and targeted drugs are mainly CTCAE grades 3 and 4 in inpatients, exhibiting various manifestations. Glucocorticoids and conventional treatments are effective. It is crucial to early diagnose and treat the skin adverse reactions. So far there is no good method to predict the development of drug adverse reactions.

Keywords

• targeted drug
• immune checkpoint inhibitors
• dermal adverse reaction