Characterization and evaluation of dermatological immune-mediated reactions associated with checkpoint inhibitors: an observational, longitudinal and retrospective study in an oncology service in Salvador/BA

Abstract

Objective: To evaluate dermatological immune-mediated reactions in patients treated with checkpoint inhibitors at an oncology center in Salvador-BA. Method: An observational, longitudinal, retrospective, descriptive, and uncontrolled study was carried out in patients undergoing treatment with checkpoint inhibitors, during the period from Jan/2021 to Dec/2021. After applying the exclusion criteria, the study’s sample size resulted in 69 patients. Electronic spreadsheets from the Excel tool (Microsoft®) were used for data processing and statistical analysis. The identification and measurement of the severity of toxicities followed the Common Toxicity Criteria, as defined by the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0. Results: The investigation found 84 immunemediated dermatological reactions occurring in 44 patients (63.77%), with the most frequent being dry skin (37%), maculopapular rash (26%), and itching (20%).The regimen with the highest incidence of reactions was the one that included pembrolizumab, with 47 occurrences. The severity of dermatological immune-mediated toxicities ranged from grade 1 to grade 2, indicating a good safety profile for these medications. Key management strategies included the use of emollients, increased fluid intake, and administration of antihistamines and corticosteroids. Conclusion: The findings of this study are aligned with the evidence from the clinical literature and highlight the importance of in-depth understanding of factors related to immunotherapy toxicity, in order to detect these reactions prematurely, optimizing management and preventing more serious complications.