Non-Small Cell Lung Cancer Coverage from Every Angle

Can Skin Reactions Portend Clinical Benefit in Patients With NSCLC?

By: Melissa E. Fryman, MS
Posted: Thursday, January 2, 2020

According to Shunichi Sugawara, MD, PhD, of Sendai Kousei Hospital, Japan, and colleagues, skin reactions in patients with advanced non–small cell lung cancer (NSCLC) treated with PD-1 antibodies, may be associated with improved survival. Although PD-1 inhibitors such as nivolumab and pembrolizumab are the current standard treatments for advanced NSCLC, immune-related adverse events—among them, skin reactions—are frequently reported.

“In [patients with] melanoma, some studies have reported that skin reactions are associated with clinical efficacy; however, little is known about this association in NSCLC,” the authors wrote. The results of their study, published in The Oncologist, provide evidence that immune-related skin reactions, and the associated predictive markers of skin reactions, may portend a clinical benefit for some patients with advanced NSCLC.

In this single-center, retrospective study, the data from 155 patients with advanced NSCLC were reviewed for the presence of skin reactions, including pruritus, rash, and erythema. All patients had previously received nivolumab or pembrolizumab monotherapy. Most patients were male and were current or former smokers (75% and 83%, respectively, P < .001). The median age of patients included in the analysis was 68 years.

Of the 155 patients included in this analysis, 51 patients reported skin reactions at a median onset time of 6.4 weeks. These patients experienced a significantly higher overall response rate than those with no skin reactions (57% vs. 19%, respectively). Moreover, median progression-free and overall survival times were also improved in patients with skin reactions (12.9 vs. 3.5 months, and not reached vs. 11.4 months, respectively). Blood samples drawn at screening included tests for preexisting rheumatoid factor, which was significantly associated with patients who developed skin reactions (43% vs. 19%, P = .003).

“To our knowledge, we are the first to report that preexisting [rheumatoid factor] is an independent predictor of the development of skin reactions…Further large-scale validation studies are warranted,” concluded the authors.

Disclosure: For full disclosures of the study authors, visit

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