Bullous disorders associated with anti-PD-1 and anti-PD-L1 therapy: A retrospective analysis evaluating the clinical and histopathologic features, frequency, and impact on cancer therapy
Document Type
Article
Publication Title
Journal of the American Academy of Dermatology
Abstract
BACKGROUND: Bullous disorders associated with anti-programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) therapy are increasingly reported and may pose distinct therapeutic challenges. Their frequency and impact on cancer therapy are not well established. OBJECTIVE: To evaluate the clinical and histopathologic findings, frequency, and impact on cancer therapy of bullous eruptions due to anti-PD-1/PD-L1 therapy. METHODS: We retrospectively reviewed the medical records of patients evaluated by the oncodermatology clinic and consultative service of Yale New Haven Hospital from 2016 to 2018. RESULTS: We identified 9 of 853 patients who developed bullous eruptions (∼1%) that were treated with an-PD-1/PD-L1 therapy at our institution during the study period: 7 presented with bullous pemphigoid, 1 presented with bullous lichenoid dermatitis, and 1 presented with linear IgA bullous dermatosis in the context of vancomycin therapy. In all, 8 patients required systemic steroids, 5 required maintenance therapy, and 8 required interruption of immunotherapy. All 9 patients had an initial positive tumor response or stable disease, but 4 went on to develop disease progression. LIMITATIONS: This was a retrospective study from a single tertiary care center. CONCLUSIONS: Bullous disorders developed in approximately 1% of patients treated with anti-PD-1/PD-L1 therapy at our institution and frequently resulted in interruption of immune therapy and management with systemic corticosteroids and occasionally steroid-sparing agents.
First Page
1081
Last Page
1088
DOI
10.1016/j.jaad.2018.07.008
Publication Date
12-1-2018
Recommended Citation
Siegel, Jacob; Totonchy, Mariam; Damsky, William; Berk-Krauss, Juliana; Castiglione, Frank; Sznol, Mario; Petrylak, Daniel P.; Fischbach, Neal; Goldberg, Sarah B.; Decker, Roy H.; Stamatouli, Angeliki M.; Hafez, Navid; Glusac, Earl J.; Tomayko, Mary M.; and Leventhal, Jonathan S., "Bullous disorders associated with anti-PD-1 and anti-PD-L1 therapy: A retrospective analysis evaluating the clinical and histopathologic features, frequency, and impact on cancer therapy" (2018). Internal Medicine. 206.
https://scholar.bridgeporthospital.org/internal_medicine/206
Identifier
30025829 (pubmed); 10.1016/j.jaad.2018.07.008 (doi); S0190-9622(18)32278-3 (pii)