Immuno-oncologyDupilumab for bullous pemphigoid related to immune checkpoint inhibitors: A retrospective case series Journal Article
| Authors: | Nykaza, I.; Moy, A.; Dusza, S. W.; Moskowitz, A.; Iyer, G.; Iqbal, A.; Motzer, R.; Ilson, D. H.; O'Cearbhaill, R. E.; Kazi, R.; Defazio, J.; Gordon, A.; Markova, A. |
| Article Title: | Immuno-oncologyDupilumab for bullous pemphigoid related to immune checkpoint inhibitors: A retrospective case series |
| Abstract: | <p>Background Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy but are associated with treatment-limiting immune-related cutaneous adverse events (irCAEs). Immune checkpoint inhibitor-related bullous pemphigoid (irBP), a severe, blistering irCAE occurs in 0.3%-1.5% of patients receiving ICI therapy. While systemic steroids can be effective, they are associated with significant toxicity and may mitigate immunotherapy antitumor efficacy. Consequently, steroid-sparing therapies are needed. Dupilumab, an IL-4 and IL-13 receptor antagonist, has demonstrated efficacy in non-ICI-related BP and appears promising for managing irBP.Methods We conducted a retrospective review of patients treated with dupilumab for irBP from April 2020 to April 2024. Clinical data, outcomes, and adverse events were assessed. Inhibitor-related bullous pemphigoid response was categorized as complete response (CR), partial response (PR), or no response (NR).Results In all, 17 patients (59% male, 82% non-Hispanic White; mean age 72.7 years) developed irBP while receiving PD-1/PDL-1 inhibitors. Sixteen patients (94%) received dupilumab for active irBP and one (6%) for prevention of recurrence. Dupilumab achieved CR of irBP for 12 patients (75%) and PR for 2 (12%) patients with active irBP. Ten (62%) achieved CR with dupilumab systemic monotherapy. Median time to first response was 19.5 days (range = 3-50). Most patients with CR (58%) failed prior oral corticosteroid therapy. The patient treated prophylactically experienced no irBP recurrence. Dupilumab was well-tolerated, with no adverse events.Conclusions Dupilumab is a promising steroid-sparing option for irBP, achieving initial response in under 20 days for most cases. Dupilumab is a valuable tool to manage this challenging irCAE while minimizing risk related to systemic steroid treatment.</p> |
| Keywords: | immunotherapy; toxicity; oncodermatology; bullous pemphigoid; dupilumab; ici |
| Journal Title: | The Oncologist |
| Volume: | 30 |
| Issue: | 9 |
| ISSN: | 1083-7159 |
| Publisher: | Oxford University Press |
| Publication status: | Published |
| Date Published: | 2025-09-01 |
| Online Publication Date: | 2025-07-10 |
| Start Page: | oyaf208 |
| Language: | English |
| ACCESSION: | WOS:001563768400001 |
| DOI: | 10.1093/oncolo/oyaf208 |
| PROVIDER: | wos |
| PMCID: | PMC12404300 |
| PUBMED: | 40638215 |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Alina Markova --Source: Wos |
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