FULL SUPPLEMENT: United States Cutaneous Oncodermatology Management (USCOM) III: A Multidisciplinary-Guided Algorithm for the Prevention and Management of Cutaneous Immunotherapy-Related Adverse Events in Cancer Patients

November 2023 | Volume 22 | Issue 11 | SF389716s1 | Copyright © November 2023


Published online October 31, 2023

Alana Deutsch MDa, Mario Lacouture MDb, Anneke Andriessen PhDc, Jennifer N Choi MDd, Alice Y Ho MDe, Beth N McLellan MDf, Edith Mitchell MDg, Jonathan S Leventhal MDa

aDepartment of Dermatology, Smilow Cancer Hospital at Yale, New Haven, CT 
bDivision of Oncodermatology, Memorial Sloan Kettering Cancer Center, New York, NY 
cRadboud UMC, Nijmegen and Andriessen Consultants, Malden, The Netherlands 
dDepartment of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL 
eDepartment of Radiation Oncology, Duke University School of Medicine, Durham, NC 
fDepartment of Medicine, Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY 
gDepartment of Medical Oncology, Center to Eliminate Cancer Disparities, Sidney Kimmel Cancer Center at Jefferson, Philadelphia, PA

Abstract
Background: In 2023, nearly 2 million patients will be diagnosed with cancer in the United States and at least 40% will be eligible for treatment with an immune checkpoint inhibitor (ICI). Cutaneous immune-related adverse events (cirAEs) from ICIs are common and include pruritus as well as maculopapular, eczematous, bullous, lichenoid, and psoriasiform reactions. All clinicians interfacing with cancer patients must expedite proper evaluation and diagnosis, treatment, and/or consultation that supports the need for evidence-directed guidelines.  
Materials and Methods: A panel of advisors was selected, and a systematic literature review generated foundational evidence to develop a treatment algorithm for cirAEs via a modified Delphi process. Iterations of the algorithm were performed until the group met a consensus.  
Results: An algorithm that tailors the management of cirAEs was developed based on the CTCAE v.5 grading of skin disorders. Representative clinical images and suggested diagnostic measures, supplement the algorithm.   
Conclusion: Recognition and treatment of cirAEs guided through a multidisciplinary, physician-developed algorithm will limit disruption of immunotherapy, optimize quality of life, and enhance overall outcomes in patients treated with ICIs. 

J Drugs Dermatol. 2023;22:11(Suppl 1):s3-10.
In the supplement: 

USCOM Algorithm for the Prevention and Management of Cutaneous Immunotherapy-Related Adverse Events
In 2023, an estimated 1,958,310 Americans will be diagnosed with cancer.1 Although overall incidence continues to rise, ongoing advancements in anticancer therapy have contributed to improved survival. Moreover, some historically fatal malignancies are now being treated akin to chronic disease, exposing a new spectrum of drug toxicities both from novel agents as well as extended duration of use. Immunotherapy, specifically immune checkpoint inhibitors (ICIs), has been a foundation of such management, with expanding indications for therapeutic interventions for cancer patients.

Read the article here.
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