Dermatologic infections in cancer patients treated with checkpoint inhibitors Journal Article
| Authors: | Do, M. H.; Barrios, D. M.; Phillips, G. S.; Postow, M. A.; Warner, A. B.; Rosenberg, J. E.; Noor, S. J.; Markova, A.; Lacouture, M. E. |
| Article Title: | Dermatologic infections in cancer patients treated with checkpoint inhibitors |
| Abstract: | Background: The incidence of dermatologic infections in patients receiving checkpoint inhibitors (CPIs) has not been systematically described. Objective: Identify the incidence of dermatologic infections in patients who received CPIs. Methods: Retrospective review of dermatologic infections in patients who received CPIs between 2005 and 2020 and were evaluated by dermatologists at Memorial Sloan Kettering Cancer Center. Results: Of 2061 patients in the study, 1292 were actively receiving CPIs (≤ 90 days since the last dose) and 769 had previously been on CPIs (> 90 days since the last dose). The dermatologic infection rate was significantly higher in patients with active CPI treatment (17.5%) than in patients not actively being treated (8.2%; P < .0001). In patients on CPIs, 82 (36.2%), 78 (34.5%), and 48 (21.2%) had bacterial, fungal, and viral infections, respectively, and 18 (8.0%) had polymicrobial infections. Anti-cytotoxic T-lymphocyte-associated antigen-4 monotherapy was associated with the highest risk of infection (hazard ratio, 2.93; 95% confidence interval, 1.87 to 4.60; P < .001). Limitations: Retrospective design and sample limited to patients referred to dermatology. Conclusions: Patients actively receiving CPIs are more susceptible to dermatologic infections, with anti-cytotoxic T-lymphocyte-associated antigen-4 monotherapy carrying the highest risk, suggesting that the index of suspicion for infections should be increased in these patients to minimize morbidity and optimize care. © 2021 American Academy of Dermatology, Inc. |
| Keywords: | adult; controlled study; human tissue; middle aged; major clinical study; prednisone; cancer patient; cancer radiotherapy; t lymphocyte; ipilimumab; skin cancer; cohort analysis; lung cancer; retrospective study; urogenital tract cancer; digestive system cancer; sarcoma; confidence interval; proportional hazards model; head and neck cancer; virus infection; skin infection; international classification of diseases; female genital tract cancer; corticosteroid therapy; infection rate; anti-ctla-4; immune checkpoint inhibitor; nivolumab; cancer; human; male; female; article; anti-pd-1; anti-pd-l1; pembrolizumab; durvalumab; atezolizumab; checkpoint inhibitors; avelumab; malignant neoplasm; cemiplimab; dermatologic infections |
| Journal Title: | Journal of the American Academy of Dermatology |
| Volume: | 85 |
| Issue: | 6 |
| ISSN: | 0190-9622 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2021-12-01 |
| Start Page: | 1528 |
| End Page: | 1536 |
| Language: | English |
| DOI: | 10.1016/j.jaad.2021.03.039 |
| PUBMED: | 33744355 |
| PROVIDER: | scopus |
| PMCID: | PMC8446092 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 December 2021 -- Source: Scopus |
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