A study published in the Journal for Immunotherapy of Cancer evaluated the safety and efficacy of immune checkpoint inhibitors (ICI) for treatment of cancer among patients with pre-existing psoriasis.

The researchers retrospectively assessed a cohort of patients from eight academic centers who had pre-existing psoriasis and were receiving ICI treatment for cancer. Seventy-six patients were included, including 62 patients (82%) with melanoma, 5 (7%) with lung cancer, 2 (3%) with head and neck cancer, and 7 (9%) with other cancers. Median follow-up was 25.1 months.

The most common psoriasis was plaque psoriasis (61%), followed by psoriatic arthritis (20%). Fifty-four percent of patients received previous psoriasis therapy, although only two patients (3%) were on systemic immunosuppression at the time of ICI initiation.

Forty-three patients (57%) experienced a psoriasis flare of cutaneous and/or extracutaneous disease, occurring after a median of 44 days of ICI initiation. Topical therapy was used in 23 patients who experienced a flare (53%), and 16 patients (21%) needed systemic therapy. Five patients (7%) required immunotherapy discontinuation for psoriasis flare.

Other immune-related adverse events occurred in 59% of patients, including 22% who experienced grade ≥3 events. Median progression-free survival and overall survival in the entire cohort were 20.0 and 87.3 months, respectively, which the authors noted “compare very favorably with previously reported survival data in phase 3 clinical trials for ICIs and in studies on patients with varying cancer types and autoimmune disease.”

In conclusion, the authors wrote, “Patients who experienced disease exacerbation performed at least as well as those who did not. Thus, pre-existing psoriasis should not prevent patients from receiving ICIs for treatment of malignancy.”

Link: Journal for Immunotherapy of Cancer https://jitc.bmj.com/content/9/10/e003066