The management of many metastatic malignancies has been revolutionised in recent years with the emergence of new biologics and reﬁnements in protocols. These agents include checkpoint inhibitors, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors, EGFR mono- clonal antibody inhibitors, and rituximab amongst others.
These diverse agents have a range of toxicities that can impact signiﬁcantly on patients, sometimes precluding fur- ther treatment. Cutaneous toxicities are not uncommon and can impact signiﬁcantly on quality of life for these patients, sometimes requiring cessation of treatment. Der- matologists are increasingly required as part of the team managing these patients.
The oncological biologics relevant to dermatology will be brieﬂy discussed including their therapeutic indications, biology, cutaneous toxicities and dermatological manage- ment. A number of interesting cases will be presented and discussion of the complex management required in patients with multiple co-morbidities.
1. Cutaneous Adverse Events of Targeted Therapies for Hema- tolymphoid Malignancies. Ransohoff JD, Kwong BY. Clin Lym- phoma Myeloma Leuk. 2017 Dec;17(12):834–851. https://doi.org/
10.1016/j.clml.2017.07.005. Epub 2017 Jul 14. Review. PMID:
2. Cutaneous toxicity as a predictive biomarker for clinical out- come in patients receiving anticancer therapy. Rzepecki AK, Cheng H, McLellan BN. J Am Acad Dermatol. 2018 Sep;79 (3):545–555. https://doi.org/10.1016/j.jaad.2018.04.046. Epub
2018 May 4. Review. PMID: 29733938
3. Cutaneous adverse effects of targeted therapies: Part II: Inhibi- tors of intracellular molecular signaling pathways. Macdonald JB, Macdonald B, Golitz LE, LoRusso P, Sekulic A. J Am Acad Dermatol. 2015 Feb;72(2):221–36; quiz 237–8. https://doi.org/10.
1016/j.jaad.2014.07.033. Review. PMID: 25592339
4. Development of Cutaneous Toxicities During Selective Anti- BRAF Therapies: Preventive Role of Combination with MEK Inhibitors. Erfan G, Puig S, Carrera C, Arance A, Gaba L, Victoria I, Garcia-Herrera A, Alos L, Malvehy J. Acta Derm
Venereol. 2017 Feb 8;97(2):258–260. https://doi.org/10.2340/
00015555-2488. No abstract available. PMID: 27353949
5. Cytotoxic Cutaneous Adverse Drug Reactions during Anti-PD-1
Therapy. Goldinger SM, Stieger P, Meier B, Micaletto S, Contas- sot E, French LE, Dummer R. Clin Cancer Res. 2016 Aug 15;22 (16):4023-9. https://doi.org/10.1158/1078-0432. CCR-15-2872. Epub 2016 Mar 8. PMID.