苔藓样反应是与抗癌剂最常见的毒性之一,最近,肿瘤学中免疫疗法的迅速出现加速了更好地表征其独特毒性特征的需要,特别是对于不太常见的皮肤毒性,包括肛门生殖器硬化性苔藓(LSA)。这个病例系列描述了四名晚期癌症患者(一名黑色素瘤,两种肺癌,和一个肾脏肿瘤)在接受免疫治疗时发展为LSA病变。回顾性审查了2017年至2020年的医疗记录。两名患者接受了pembrolizumab,抗程序性细胞死亡-1(PD-1),一个Nivolumab,抗程序性细胞死亡-1(PD-1),还有一个ipilimumab,一种免疫检查点抑制剂.LSA在中位数为3个月后出现(范围,2-4个月)从开始免疫疗法。所有LSA病例均为2级。3例发生在阴茎上,1例发生在肛门上。所有患者在LSA的特定治疗后有所改善,且未报告LSA相关抗肿瘤治疗中断/危及生命的情况.迄今为止,这是与免疫治疗相关的LSA病变的首例系列病例.早期LSA识别和管理对接受免疫治疗的癌症患者有帮助,允许长期存活和治疗反应。
Lichenoid reactions are one of the most frequently observed toxicities with anticancer agents and, recently, a rapid emergence of immunotherapies in oncology has hastened the need to better characterize their unique toxicity profiles, particularly for less common skin toxicities, including
anogenital lichen sclerosus et atrophicus (LSA). This
case series describes four patients with advanced cancer (one melanoma, two lung cancers, and one kidney tumor) developing LSA lesions while receiving an immunotherapy. Medical records from 2017 to 2020 were retrospectively reviewed. Two patients received pembrolizumab, anti-programmed cell death-1 (PD-1), one nivolumab, anti-programmed cell death-1 (PD-1), and one ipilimumab, an immune checkpoint inhibitor. LSA emerged after a median of 3 months (range, 2-4 months) from starting immunotherapy. All LSA cases were grade 2. Three cases occurred on the penis and one
case on the anus. All patients improved after a specific treatment for LSA, and no LSA-related antineoplastic treatment interruption/life-threatening condition were reported. To date, this is the first
case series of LSA lesions associated with immunotherapy. Early LSA recognition and management is helpful in cancer patients on immunotherapy allowing a long survival and treatment response.