Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting PD-1 and PD-L1 Journal Article


Authors: Naidoo, J.; Schindler, K.; Querfeld, C.; Busam, K.; Cunningham, J.; Page, D. B.; Postow, M. A.; Weinstein, A.; Lucas, A. S.; Ciccolini, K. T.; Quigley, E. A.; Lesokhin, A. M.; Paik, P. K.; Chaft, J. E.; Segal, N. H.; D'Angelo, S. P.; Dickson, M. A.; Wolchok, J. D.; Lacouture, M. E.
Article Title: Autoimmune bullous skin disorders with immune checkpoint inhibitors targeting PD-1 and PD-L1
Abstract: Monoclonal antibodies (mAb) targeting immune checkpoint pathways such as cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed death 1 (PD-1) may confer durable disease control in several malignancies. In some patients, immune checkpoint mAbs cause cutaneous immune-related adverse events. Although the most commonly reported cutaneous toxicities are mild, a subset may persist despite therapy and can lead to severe or life-threatening toxicity. Autoimmune blistering disorders are not commonly associated with immune checkpoint mAb therapy. We report a case series of patients who developed bullous pemphigoid (BP), an autoimmune process classically attributed to pathologic autoantibody formation and complement deposition. Three patients were identified. Two patients developed BP while receiving the anti-PD-1 mAb nivolumab, and one while receiving the anti-PD-L1 mAb durvalumab. The clinicopathologic features of each patient and rash, and corresponding radiologic findings at the development of the rash and after its treatment, are described. Patients receiving an anti-PD-1/PD-L1 mAb may develop immune-related BP. This may be related to both T-cell- and B-cell-mediated responses. Referral to a dermatologist for accurate diagnosis and management is recommended. ©2016 American Association for Cancer Research.
Journal Title: Cancer Immunology Research
Volume: 4
Issue: 5
ISSN: 2326-6066
Publisher: American Association for Cancer Research  
Date Published: 2016-05-01
Start Page: 383
End Page: 390
Language: English
DOI: 10.1158/2326-6066.cir-15-0123
PROVIDER: scopus
PUBMED: 26928461
PMCID: PMC5241697
DOI/URL:
Notes: Article -- Export Date: 2 August 2016 -- Source: Scopus
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MSK Authors
  1. Elizabeth Ann Quigley
    21 Quigley
  2. Mario E Lacouture
    457 Lacouture
  3. Jedd D Wolchok
    905 Wolchok
  4. Neil Howard Segal
    209 Segal
  5. Michael Andrew Postow
    361 Postow
  6. Jamie Erin Chaft
    289 Chaft
  7. Sandra Pierina D'Angelo
    252 D'Angelo
  8. Paul K Paik
    255 Paik
  9. Mark Andrew Dickson
    169 Dickson
  10. Klaus J Busam
    688 Busam
  11. Alexander Meyer Lesokhin
    363 Lesokhin