title: Characterization of nivolumab-associated skin reactions in patients with metastatic non-small cell lung cancer.
abstract: Immune checkpoint inhibitors have led to considerable therapy improvement in cancer patients. Autoimmune side effects including skin reactions are frequently observed. In melanoma, those include rash and vitiligo and were shown to be associated with a prolonged overall survival. Little is known about skin reactions in non-small cell lung cancer (NSCLC) patients during immunotherapy. Here, we retrospectively investigated immune-related adverse skin reactions (irAEs) in 40 patients with metastatic NSCLC treated with the anti-PD-1 antibody nivolumab. 7 out of 40 patients (17%) developed an irAEs. Skin irAEs correlated with tumor responses in 5 of 12 responders (42%) as compared to 2 of 27 non-responders (7%). Histologically, scaly plaques showed dermatitis consisting mainly of lymphocytes. We observed a positive correlation between skin irAEs and tumor responses in patients with NSCLC treated with nivolumab. Patterns of lymphocytic skin infiltration differed depending on the histological tumor subtype (adenocarcinoma versus squamous cell carcinoma NSCLC).
authors.affiliation: Department of Dermatology and Allergology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Institute of Immunobiolology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
authors.forename: Omar
authors.initials: O
authors.lastname: Hasan Ali
authors.affiliation: Department of Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Department of Oncology and Hematology, Hospital Grabs, Grabs, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Diem
authors.affiliation: Institute of Pathology, Cantonal Hospital St. Gallen , St. Gallen, Switzerland.
authors.forename: Eva
authors.initials: E
authors.lastname: Markert
authors.affiliation: Institute of Pathology, Cantonal Hospital St. Gallen , St. Gallen, Switzerland.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Jochum
authors.affiliation: Department of Dermatology, University Hospital of Zurich , Zurich, Switzerland.
authors.forename: Katrin
authors.initials: K
authors.lastname: Kerl
authors.affiliation: Department of Dermatology, University Hospital of Zurich , Zurich, Switzerland.
authors.forename: Lars E
authors.initials: LE
authors.lastname: French
authors.affiliation: Department of Oncology and Ludwig Cancer Research, University of Lausanne , Lausanne, Switzerland.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Speiser
authors.affiliation: Department of Oncology and Hematology, Cantonal Hospital St. Gallen , St. Gallen, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Früh
authors.affiliation: Department of Dermatology and Allergology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Institute of Immunobiolology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Lukas
authors.initials: L
authors.lastname: Flatz
keywords: Anti-PD1; histology; immunotherapy; non-small cell lung cancer; skin eruption