Characterization of dermatitis after PD-1/PD-L1 inhibitor therapy and association with multiple oncologic outcomes: A retrospective case-control study
Characterization of dermatitis after PD-1/PD-L1 inhibitor therapy and association with multiple oncologic outcomes: A retrospective case-control study
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DOI：
10.1016/j.jaad.2018.05.035
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发表时间：
2018-12-01
影响因子：
13.8
通讯作者：
Chang, Anne Lynn S.
中科院分区：
文献类型：
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作者：
Lee, Charles Kyung Min;Li, Shufeng;Chang, Anne Lynn S.
背景：皮肤不良事件在程序性死亡1 (PD-1)/程序性死亡配体1 （PD-L1）抑制剂中很常见。然而，各种PD-1/PD-L1抑制剂对皮炎特异性皮肤不良事件的性质尚未进行研究。与皮炎潜在相关的肿瘤预后尚未得到很好的表征。目的：评估暴露于PD-1/PD-L1抑制剂后皮炎的性质和与皮炎相关的肿瘤预后。方法：在单一学术中心进行回顾性、配对、病例对照研究。结果：最常见的组织学类型为苔藓样皮炎（50%）和海绵状皮炎（40%）。病例患者的总体肿瘤缓解率为65.0%，对照组为17.0% (P= 0.0007)（优势比为7.3；95%可信区间为2.3-23.1）。Kaplan-Meier分析显示，病例患者的无进展生存期和总生存时间明显长于对照组（P < 0.0001, P < 0.0001）。0203年,分别)。局限性：回顾性设计和相对较小的样本量排除了所有癌症类型的匹配。结论：与PD-1/PD-L1抑制剂相关的地衣样物质和海绵性皮炎可能是免疫反应增强和肿瘤预后改善的标志。PD-1/ pd - l1相关皮炎在预测癌症预后方面的价值有待通过针对特定癌症类型的前瞻性多中心研究来进一步研究。
Background: Cutaneous adverse events are common with programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors. However, the nature of the specific cutaneous adverse event of dermatitis has not been investigated across various PD-1/PD-L1 inhibitors. Oncologic outcomes potentially associated with dermatitis are not well characterized.Objective: To assess the nature of dermatitis after exposure to a PD-1/PD-L1 inhibitor and oncologic outcomes associated with dermatitis.Methods: Retrospective, matched, case-control study conducted at a single academic center. Results: The most common histologic patterns were lichenoid dermatitis (50%) and spongiotic dermatitis (40%). The overall tumor response rate was 65.0% for the case patients and 17.0% for the controls (P=.0007) (odds ratio, 7.3; 95% confidence interval, 2.3-23.1). The progression-free survival and overall survival times were significantly longer for the case patients than for the controls by Kaplan-Meier analysis (P < .0001 and.0203, respectively).Limitations: The retrospective design and relatively small sample size precluded matching for all cancer types.Conclusions: Lichenoid and spongiotic dermatitis associated with PD-1/PD-L1 inhibitors could be a sign of robust immune response and improved oncologic outcomes. The value of PD-1/PD-L1erelated dermatitis in predicting cancer outcomes awaits investigation through prospective multicenter studies for specific cancer types.