Cutaneous toxicities of new treatments for melanoma

Clin Transl Oncol. 2018 Nov;20(11):1373-1384. doi: 10.1007/s12094-018-1891-7. Epub 2018 May 24.

Abstract

New drugs against advanced melanoma have emerged during last decade. Target therapy and immunotherapy have changed the management of patients with metastatic disease. Along with its generalized use, drug toxicities have appeared and the skin is the target organ of a significant part of them. This revision summarizes the most common side effects and consensus management to improve the compliance of therapies and patients' quality of life. Among the BRAF inhibitors, main cutaneous side effects are photosensitivity, plantar hyperkeratosis, and the appearance of verrucal keratosis or squamous cell carcinoma. Special attention must be paid to the development of new primary melanomas or changes on nevi during BRAF inhibitor therapy. The most common cutaneous side effects of immunotherapy are rash, pruritus, and vitiligo. It remains controversial the possible role of these toxicities as markers of response to therapy.

Keywords: Immunotherapy; Melanoma; Nivolumab; Pembrolizumab; Target therapy; Toxicity.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Drug Eruptions / etiology*
  • Drug Eruptions / pathology
  • Drugs, Investigational / adverse effects*
  • Humans
  • Immunotherapy / adverse effects*
  • Melanoma / pathology
  • Melanoma / therapy*
  • Molecular Targeted Therapy / adverse effects*
  • Molecular Targeted Therapy / methods
  • Nivolumab / administration & dosage
  • Nivolumab / adverse effects
  • Protein Kinase Inhibitors / therapeutic use
  • Proto-Oncogene Proteins B-raf / genetics
  • Proto-Oncogene Proteins B-raf / immunology
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*
  • Therapies, Investigational / adverse effects*

Substances

  • Antibodies, Monoclonal, Humanized
  • Drugs, Investigational
  • Protein Kinase Inhibitors
  • Nivolumab
  • pembrolizumab
  • Proto-Oncogene Proteins B-raf