melanoma patients

Dr. Edwards has recently completed a retrospective review of our melanoma patients at The Royal Marsden developing cutaneous toxicity while receiving checkpoint inhibitor therapy. ‘Cutaneous toxicities in patients with melanoma receiving checkpoint inhibitor therapy: a retrospective review. The experience of a single large specialist institution.’

Checkpoint inhibitors have significantly improved the overall survival for several cancers and have also gained recent approval for adjuvant use in melanoma patients.

Modulating the immune system however is associated with potential side effects the most common of these being cutaneous side effects. We conducted a retrospective review of our adult patients with melanoma who between 2006 and 2018 received nivolumab, pembrolizumab or ipilimumab. This study which covers 12 years is the largest study of cutaneous side effects of checkpoint inhibitors in melanoma patients. Our results show that cutaneous toxicity occurs in at least 24% of patients, some developing more than 1 episode of toxicity. Grade 3 and 4 severity skin toxicities occurred in over 13% of patients with less than 5% of patients requiring treatment discontinuation.

Our study confirms that overall most cases are mild but severe reactions do occur. Prompt recognition and treatment can control the impact on quality of life and potentially allow urgent treatment to be administered when needed. It is important that these patients are managed both by an oncologist and dermatologist.

Read more here – https://doi.org/10.1111/ced.14469

To arrange an appointment with Dermatologist Dr Kara Heelan, at Chelsea Outpatient Centre or Sydney Street Outpatients & Diagnostic Centre call us on 0203 494 4024.

Systemic treatment

Well done to Dr Ferguson and Dr Ho. Our case ‘Extensive mucocutaneous, oesophageal and otic lichen planus secondary to Nivolumab therapy’ has recently been published in Skin Health and Disease.

Anti-PD-1 therapy is a type of immunotherapy and an area in increasing development for its efficacy and advantages in the treatment of advanced metastatic melanoma.

Lichenoid reactions are well recognised within the context of anti-PD-1 therapy. We report a rare case of lichen planus occurring in the mucous membranes, oesophagus and otic canal. This case highlights the importance of considering systemic involvement in these patients. These cases can be difficult to treat especially within the context of malignancy.

Read more here – https://doi.org/10.1002/ski2.8

To arrange an appointment with Dr Kara Heelan, at Chelsea Outpatient Centre or Sydney Street Outpatients & Diagnostic Centre call us on 0203 494 4024.

HER2-Positive Breast Cancer

Congratulations to Dr Chawla who has recently written a case report entitled ‘Annular atrophic lichen planus induced by anti-HER2 antibodies’. This has been published in the Australasian Journal of Dermatology.

Monoclonal inhibitors Pertuzumab and Trastuzumab inhibit human epidermal growth factors receptor 2 (HER-2). These are used to treat HER-2 positive breast cancer. Our case highlights a rare variant of a lichenoid drug eruption in a 35 year old female. Recognising rare potential side effects can ensure patients do not require treatment interruption.

Read the article by visiting here.

To arrange an appointment with Dr Kara Heelan, at Chelsea Outpatient Centre or Sydney Street Outpatients & Diagnostic Centre call us on 02034944024.