Ipilimumab in patients with cancer and the management of dermatologic adverse events Journal Article
| Authors: | Lacouture, M. E.; Wolchok, J. D.; Yosipovitch, G.; Kähler, K. C.; Busam, K. J.; Hauschild, A. |
| Article Title: | Ipilimumab in patients with cancer and the management of dermatologic adverse events |
| Abstract: | Ipilimumab is a fully human monoclonal antibody that blocks cytotoxic T-lymphocyte antigen-4 to augment antitumor T-cell responses. Phase III studies have demonstrated survival benefit in both previously treated and treatment-naïve patients with metastatic melanoma. In clinical trials, adverse events (AEs) related to treatment with ipilimumab were mostly grade 1/2 (as per Common Terminology Criteria for AEs, Version 4.02), and mostly reversible with appropriate management. Distinct immune-related AEs that may reflect the mechanism of action of ipilimumab have been identified, and occur commonly in the skin, typically presenting as a maculopapular rash, which can be accompanied by pruritus, pruritus with no skin lesions, alopecia, and vitiligo. Histologic analyses have revealed epidermal spongiosis, and perivascular CD4+ T-cell infiltrates with some eosinophils in areas of rash. Timely implementation of toxicity-specific treatment guidelines that emphasize vigilance and early intervention allows mitigation of dermatologic AEs. Adherence to guidelines is necessary to maintain quality of life, ensure consistent dosing, and obtain the best possible clinical outcome. © 2014 by the American Academy of Dermatology, Inc. |
| Keywords: | prednisone; review; erlotinib; drug efficacy; drug safety; monotherapy; cancer patient; cd8+ t lymphocyte; dacarbazine; glycoprotein gp 100; ipilimumab; melanoma; quality of life; ovary cancer; skin biopsy; skin defect; incidence; practice guideline; cell differentiation; antineoplastic activity; cetuximab; risk factor; histology; punch biopsy; panitumumab; pruritus; rash; maculopapular rash; cd4+ t lymphocyte; vandetanib; erythema; colitis; melan a; skin disease; hypothyroidism; lymphocytic infiltration; disease control; cytotoxic t lymphocyte antigen 4; cd3+ t lymphocyte; cytokine release; alopecia; cell expansion; t lymphocyte activation; epidermal growth factor receptor kinase inhibitor; ophthalmology; pertuzumab; stevens johnson syndrome; toxic epidermal necrolysis; adult respiratory distress syndrome; metastatic melanoma; early intervention; visual acuity; lamotrigine; hypopituitarism; vitiligo; eosinophil; dermatologic; pigment epithelium; alertness; leukocytoclastic vasculitis; immune-related; human; priority journal; adverse event management |
| Journal Title: | Journal of the American Academy of Dermatology |
| Volume: | 71 |
| Issue: | 1 |
| ISSN: | 0190-9622 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2014-07-01 |
| Start Page: | 161 |
| End Page: | 169 |
| Language: | English |
| DOI: | 10.1016/j.jaad.2014.02.035 |
| PROVIDER: | scopus |
| PUBMED: | 24767731 |
| DOI/URL: | |
| Notes: | Export Date: 1 August 2014 -- CODEN: JAADD -- Source: Scopus |
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