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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Friday, September 26, 2025
Proactive, multidisciplinary intervention significantly reduced the severity of dermatologic immune-related adverse events (irAEs) during immune checkpoint inhibitor therapy for non–small cell lung cancer (NSCLC), according to a Japanese single‐center, retrospective observational study published in JCO Oncology Practice.
The study included 154 treatment-naïve patients with NSCLC who had received nivolumab + ipilimumab, with or without chemotherapy. The study authors compared skin toxicities and clinical outcomes from before the implementation of a prophylactic intervention to those afterward. Intervention included medication, patient education, and skincare.
Among 154 treatment-naïve NSCLC patients, the incidence of grade 3 skin toxicities decreased from 21% to 8% after implementation. Rates of systemic corticosteroid use dropped from 36% to 10%, and treatment discontinuation due to dermatologic toxicity fell from 21% to 4%. Patients who developed any grade of skin rash had significantly longer progression-free survival (median 10.0 vs 3.7 months; HR 0.54, P=.001) and overall survival (median 31.3 vs 11.8 months; HR 0.48, P=.0016) than those with no dermatologic adverse events. However, overall survival among those with grade 3 skin toxicities was inferior compared to those with grade 1-2 rashes.
“These outcomes suggest that early and proactive management of irAEs can improve treatment tolerability and continuity without compromising treatment efficacy,” the study authors concluded. “The reduction in grade 3 skin toxicities from 21% to 8% after prophylactic intervention is particularly noteworthy. Severe skin toxicities have been reported as a major contributor to treatment interruptions and adverse outcomes in ICI therapy.”
The study authors also advocated for larger, prospective, multicenter studies to be conducted in the future.
Disclosures: For full disclosures of study authors, visit ascopubs.org.
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