Kutane Nebenwirkungen unter Immun-Checkpoint-Inhibitor-Therapie

Zusammenfassung

Moderne Immuntherapeutika wie Nivolumab, Pembrolizumab oder Ipilimumab, die sogenannte Immun-Checkpoints blockieren, haben die onkologische Therapie in den letzten Jahren revolutioniert. Mit dem neuen Wirkmechanismus der Blockade wichtiger Kontrollpunkte im Immunsystem zeigen sich jedoch auch eine Vielzahl an unterschiedlichen Nebenwirkungen. Diese treten nicht selten an der Haut auf. Zu den häufigsten dermalen Reaktionen unter Immuntherapie zählen die Vitiligo, Exantheme, blasenbildende Reaktionen oder der Lichen planus. Ausgeprägter Juckreiz kann Patienten stark beeinträchtigen. Der Verlauf bei auf die Haut beschränkten Nebenwirkungen ist häufig mild und gut zu behandeln oder selbstlimitierend. Hauterscheinungen können jedoch auch als Symptom systemischer Reaktionen auftreten. Eine frühe Diagnosestellung, die Einleitung einer adäquaten Therapie sowie eine interdisziplinäre Betreuung bei komplexen Erkrankungen sind entscheidend, um dauerhafte Einschränkungen für die Patienten zu verhindern und eine sichere Behandlung der zugrundeliegenden Tumorerkrankung gewährleisten zu können.

Abstract

Modern immunotherapies such as nivolumab, pembrolizumab or ipilimumab have profoundly changed oncological therapy in recent years. With this new mechanism of action of blocking important checkpoints of the immune system, however, a large number of different adverse effects have become apparent and the skin is frequently involved. The most common dermal reactions related to immune-checkpoint inhibition include vitiligo, exanthema, blistering reactions or lichen planus. Pronounced itching can greatly affect patients’ quality of life. The course of cutaneous reactions is often mild and therapy is uncomplicated, or events are self-limiting. However, skin reactions can also occur as a symptom of systemic reactions. An early diagnosis, initiation of adequate therapies as well as an interdisciplinary approach in complex situations are crucial to prevent permanent impairments for patients and to assure safe treatment of the underlying malignancy.

Schlüsselwörter

Immuntherapie - Hautreaktion - PD-1-Inhibitor - Exanthem

Keywords

immunotherapy - skin reaction - PD-1-inhibitor - exanthema

Publication History

Received: 14 February 2022

Accepted: 03 May 2022

Article published online:
17 November 2023

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