Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of severe dermatological toxicities from checkpoint inhibitors

Support Care Cancer. 2020 Dec;28(12):6119-6128. doi: 10.1007/s00520-020-05706-4. Epub 2020 Aug 27.

Abstract

Immune checkpoint inhibitors (ICIs) frequently result in cutaneous immune-related adverse events (IrAEs). Although the majority of these events are mild-to-moderate in severity, up to 5% are severe, which may lead to morbidity and dose interruption or discontinuation of ICI therapy. In addition, up to 25% of dermatologic IrAEs are corticosteroid-refractory or corticosteroid-dependent. These 2020 MASCC recommendations cover the diagnosis and management of cutaneous IrAEs with a focus on moderate-to-severe and corticosteroid-resistant events. Although the usage of immune-suppressive therapy has been advocated in this setting, there is a lack of randomized clinical trial data to provide a compelling level of evidence of its therapeutic benefit.

Keywords: Bullous dermatoses; Corticosteroids; Cutaneous IrAEs; Inflammatory dermatitis; Pruritus; Skin rash; Vitiligo.

Publication types

  • Historical Article
  • Practice Guideline
  • Review

MeSH terms

  • Drug Eruptions / etiology
  • Drug Eruptions / pathology
  • Drug Eruptions / therapy*
  • History, 21st Century
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Immunotherapy / adverse effects
  • International Agencies / organization & administration
  • International Agencies / standards
  • Neoplasms / immunology
  • Neoplasms / therapy*
  • Palliative Care* / methods
  • Palliative Care* / standards
  • Palliative Medicine / organization & administration
  • Palliative Medicine / standards
  • Severity of Illness Index
  • Societies, Medical / organization & administration
  • Societies, Medical / standards

Substances

  • Immune Checkpoint Inhibitors