Vitiligo-like depigmentation in oncology patients treated with immunotherapies for nonmelanoma metastatic cancers

R C Liu; G Consuegra; S Chou; P Fernandez Peñas

doi:10.1111/ced.13867

Vitiligo-like depigmentation in oncology patients treated with immunotherapies for nonmelanoma metastatic cancers

Clin Exp Dermatol. 2019 Aug;44(6):643-646. doi: 10.1111/ced.13867. Epub 2019 Jan 7.

Authors

R C Liu^{1

2}, G Consuegra^{1

2}, S Chou³, P Fernandez Peñas^{1

2}

Affiliations

¹ Department of Dermatology, Westmead Hospital, Sydney, Australia.
² Westmead Clinical School, the University of Sydney Medical School, Sydney, Australia.
³ Tissue Pathology and Diagnostic Oncology, Westmead Hospital, Sydney, Australia.

PMID: 30618056
DOI: 10.1111/ced.13867

Abstract

Vitiligo-like depigmentation (VLD) is a characteristic cutaneous event described in patients with metastatic malignant melanoma receiving treatment with immune checkpoint inhibitors. We report the onset of VLD in three patients with other cancer types (cholangiocarcinoma, renal cell carcinoma and squamous cell carcinoma) following treatment with immunotherapy (combination pembrolizumab and nivolumab for the first, and pembrolizumab for the other two cancer types). Cases of VLD have not been reported previously in patients treated for any of these cancers, to our knowledge. Pembrolizumab and nivolumab are monoclonal antibodies targeting programmed cell death (PD)-1 receptors, while ipilimumab targets cytotoxic T-lymphocyte antigen-4. Our clinical finding challenges the current understanding of VLD as a malignant melanoma-specific immunotherapy-related adverse event.

Publication types

Case Reports

MeSH terms

Aged
Antibodies, Monoclonal, Humanized / administration & dosage
Antibodies, Monoclonal, Humanized / adverse effects
Antibodies, Monoclonal, Humanized / therapeutic use
Antineoplastic Agents, Immunological / administration & dosage
Antineoplastic Agents, Immunological / adverse effects
Antineoplastic Agents, Immunological / therapeutic use
CTLA-4 Antigen / antagonists & inhibitors
Carcinoma, Renal Cell / drug therapy
Carcinoma, Renal Cell / pathology
Carcinoma, Squamous Cell / drug therapy
Carcinoma, Squamous Cell / pathology
Cholangiocarcinoma / drug therapy
Cholangiocarcinoma / pathology
Humans
Hypopigmentation / chemically induced
Immunotherapy / adverse effects*
Infusions, Intravenous
Lung Neoplasms / pathology
Male
Melanoma / pathology
Melanoma / secondary*
Middle Aged
Nivolumab / administration & dosage
Nivolumab / adverse effects
Nivolumab / therapeutic use
Pigmentation Disorders / chemically induced
Pigmentation Disorders / pathology
Programmed Cell Death 1 Receptor / antagonists & inhibitors
Vitiligo / chemically induced*
Vitiligo / pathology

Substances

Antibodies, Monoclonal, Humanized
Antineoplastic Agents, Immunological
CTLA-4 Antigen
CTLA4 protein, human
Programmed Cell Death 1 Receptor
Nivolumab
pembrolizumab