Abstract
Checkpoint inhibitors have revolutionized advanced melanoma care; however, their cutaneous side effects have not been definitively elucidated. To identify the prevalence of cutaneous toxicity in patients with melanoma treated with immune checkpoint inhibitors as monotherapy and/or in combination with chemotherapy and/or radiotherapy. We performed a systematic review and meta-analysis, which encompassed both clinical trials and observational studies describing the dermatological toxicities in patients treated with immune checkpoint inhibitors. The protocol was registered in the International Prospective Register of Systematic Review under the number CRD42018091915. The searches were performed using the CINAHL, Cochrane CENTRAL, LILACS, LIVIVO, PubMed, Scopus, and Web of Science databases. The methodological quality of the studies was evaluated with the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data. A total of 9,802 articles were identified in the databases. The final sample comprised 39 studies. The evaluated drugs were ipilimumab, tremelimumab, pembrolizumab, and nivolumab. The results suggest that the most prevalent side effect was grade 1 and 2 pruritus (24%), followed by grade 1 and 2 rash (21%) and grade 1 and 2 vitiligo (10%). The most prevalent side effects in patients treated with checkpoint inhibitors are pruritus, rash, and vitiligo, and they are rated mostly as grades 1 and 2 adverse events. Remarkably, vitiligo is most commonly found in patients treated with PD-1 inhibitors.
Highlights
Immune checkpoint inhibitors (ICIs), which were originally introduced for the treatment of melanoma during the last decade, have revolutionized cancer therapy [1,2]
The side effects related to ICIs are labeled as immune-related adverse events and are thought to be related to the inflammatory response caused in several organs due to the stimulation of the immune system, especially of T cells [9,10,11]
The following information was recorded: study characteristics; sample characteristics; duration of the drug treatment and follow-up; and characteristics of the results
Summary
Immune checkpoint inhibitors (ICIs), which were originally introduced for the treatment of melanoma during the last decade, have revolutionized cancer therapy [1,2]. ICIs act as co-stimulatory inhibitory receptor antagonists to counteract the deactivation of the immune system caused by the tumor and to promote immune activation [4,5]. The side effects related to ICIs are labeled as immune-related adverse events (irAEs) and are thought to be related to the inflammatory response caused in several organs due to the stimulation of the immune system, especially of T cells [9,10,11]. Checkpoint inhibitors have revolutionized advanced melanoma care; their cutaneous side effects have not been definitively elucidated
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