Meta-analysis of Treatment of Skin Cancers With PD-1/PD-L1 Inhibitors
Posted: Monday, July 8, 2019
PD-L1 and PD-1 inhibitors have shown treatment efficacy in many non-melanoma skin cancers. This is the conclusion of a meta-analysis of 51 articles in the medical literature, which was published in the Journal of the American Academy of Dermatology. However, Franchesca D. Choi, BS, RPh, of the University of California Irvine, and colleagues cautioned that further investigation is necessary to determine tumor responsiveness and safety of these immunotherapies in this patient population.
“The role of PD-1 and PD-L1 inhibitors in advanced [non-melanoma skin cancers] is promising, with utility in advanced [cutaneous squamous cell carcinoma], [basal cell carcinoma], [Merkel cell carcinoma], cutaneous soft-tissue sarcomas, sebaceous carcinoma, and malignant peripheral nerve sheath tumors,” concluded the authors.
Researchers conducted a primary literature search through October 2018 to find studies on PD-L1 and PD-1 inhibitors in people with non-melanoma skin cancer. Their search yielded 51 studies, with the most robust data from phase I and II trials supporting the use of PD-1 and PD-L1 inhibitors in Merkel cell carcinoma and cutaneous squamous cell carcinomas. However, limited data exist to support the use of these agents in the treatment of basal cell carcinoma, cutaneous sarcoma, sebaceous carcinoma, and malignant peripheral nerve sheath tumors, although the therapy does seem to be beneficial in these skin cancers. There were no studies suggesting these therapies were efficacious in the treatment of cutaneous lymphomas.
The immunotherapies included in this review were cemiplimab, nivolumab, pembrolizumb in both basal cell and squamous cell carcinomas and avelumab, nivolumab, and pembrolizumab in Merkel cell carcinoma. The rate of grade 3 or 4 adverse events with these agents in the clinical trials evaluated was approximately 15%.
Disclosure: The study authors’ disclosure information may be found at jaad.org.