Abstract
BACKGROUND: Programmed cell death protein (ligand) 1 (PD-(L)1) inhibitors are well established in the treatment of dermatological tumors. Mostly, they are well tolerated, but in about 9-21% of patients, grade 3/4 immune-related adverse events (irAEs) occur. As treatment options are limited, it is of interest to determine whether readministration of another or the same PD-(L)1 inhibitor is safe. METHODS: This is a multicenter, retrospective study on patients with metastasized dermatological tumors who were retreated with either the same or a different PD-(L)1 inhibitor after the development of irAEs. The study was conducted at centers in Heidelberg, Zurich, and Frankfurt. RESULTS: 22 patients were included between April 2020 and December 2022 with a median age of 71 years. A total of 13 (59%) patients were re-exposed with the same antibody and nine (41%) received a different PD-(L)1 inhibitor. Six (46%) of the patients who were re-exposed to the same antibody had an irAE, of which 67% were identical with the first. In patients receiving a different PD-(L)1 inhibitor, four (44%) developed an irAE, of which 75% were identical with the first. CONCLUSIONS: Both an intraclass switch of PD-(L)1 inhibitor treatment and re-exposure with the same antibody after an irAE can be considered as options with a fair chance of improving therapy tolerance.