What Skin Toxicities May Signal in Melanoma Patients on Immunotherapy
Cutaneous immune-related adverse events (irCAEs) are among the most common side effects seen in patients receiving immune checkpoint inhibitors (ICIs) for advanced melanoma —but could they offer more than just a dermatologic challenge?
In a May JDD article, “Cutaneous Immune-Related Adverse Events Associated With Immunotherapy in Patients With Melanoma” (J Drugs Dermatol. 2025;24(5):490–493), researchers at Moffitt Cancer Center looked back at 147 patients with stage III or IV melanoma to explore whether skin toxicities predicted broader systemic immune-related adverse events (irAEs).
Among patients on first-line ICIs, there was no significant link between developing irCAEs and other systemic side effects. But in patients who progressed and received second-line immunotherapy, those who developed irCAEs were significantly more likely to also experience systemic irAEs (P < 0.001). Interestingly, median overall survival was longer in patients who had irCAEs (118 months vs. 69 months), though this finding did not reach statistical significance.
For dermatologists and oncologists alike, this study adds nuance to how we view skin toxicities—not just as side effects, but as possible markers of immune activation, especially in later lines of therapy. Collaboration between specialties remains key to managing these patients holistically.
