{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:25:37Z","timestamp":1790717137624,"version":"4.1.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Pruritus is a frequent adverse event during the use of immune checkpoint inhibitors (ICIs), with a frequency estimated to be between 11 and 47%. The underlying causes remain poorly understood.<\/jats:p><jats:p><jats:bold>Objectives:<\/jats:bold> The main goal was to search for putative causes of pruritus occurring in patients treated with ICIs for melanomas and cutaneous carcinomas. Other objectives were to assess the association between the occurrence of pruritus and survival and between the occurrence of pruritus and other adverse events.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A monocentric retrospective descriptive study was performed using data for patients treated with ICIs (nivolumab, pembrolizumab, ipilimumab, and cemiplimab) between August 2010 and November 2019.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> A total of 181 patients were included (mean age: 69 years). Pruritus was reported by 25 patients (13.8%). We were able to determine three subgroups of pruritus causes under ICI use: pruritus directly related to immunotherapy, pruritus indirectly related through other pruritus-inducing side effects and pruritus unrelated to ICIs. In 6\/25 patients, no more specific cause of pruritus was found at the onset of pruritus or in their backgrounds, other than ICI use.<\/jats:p><jats:p><jats:bold>Limitations:<\/jats:bold> The study has some limitations due to unicentric and retrospective design.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Pruritus was found in 25\/181 patients in this series; only in 6\/25 patients no potential cause other than ICI could be found, and pruritus was not associated with differences in survival.<\/jats:p>","DOI":"10.3389\/fmed.2021.632683","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T04:45:19Z","timestamp":1612845919000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Causes of Pruritus in Patients Treated With Immune Checkpoint Inhibitors for Melanomas or Skin Carcinomas"],"prefix":"10.3389","volume":"8","author":[{"given":"Nadia","family":"Salinas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Nowak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime","family":"Etienne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Legoupil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime","family":"Fouchard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Brenaut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Misery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,2,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"987","DOI":"10.2217\/imt-2017-0143","article-title":"Immunotherapy in melanoma","volume":"10","author":"Feld","year":"2018","journal-title":"Immunotherapy."},{"key":"B2","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1080\/17512433.2019.1665026","article-title":"Cemiplimab-rwlc as first and only treatment for advanced cutaneous squamous cell carcinoma","volume":"12","author":"Ahmed","year":"2019","journal-title":"Expert Rev Clin Pharmacol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1586\/14737140.2015.1074862","article-title":"Nivolumab and pembrolizumab as immune-modulating monoclonal antibodies targeting the PD-1 receptor to treat melanoma","volume":"15","author":"Faghfuri","year":"2015","journal-title":"Expert Rev Anticancer Ther."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1007\/s40262-019-00789-7","article-title":"Immune checkpoint inhibitors in melanoma: a review of pharmacokinetics and exposure-response relationships","volume":"58","author":"Leven","year":"2019","journal-title":"Clin Pharmacokinet."},{"key":"B5","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1159\/000478081","article-title":"Adverse reactions to biologics: melanoma (Ipilimumab, Nivolumab, Pembrolizumab)","volume":"53","author":"Hwang","year":"2018","journal-title":"Curr Probl Dermatol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.anplas.2012.02.002","article-title":"Dermatologic adverse events of the new targeted anticancer therapies used in oncodermatology","volume":"57","author":"Sibaud","year":"2012","journal-title":"Ann Chir Plast Esthet."},{"key":"B7","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s11864-016-0434-0","article-title":"Cutaneous complications of targeted melanoma therapy","volume":"17","author":"de Golian","year":"2016","journal-title":"Curr Treat Options Oncol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1007\/s12094-018-1891-7","article-title":"Cutaneous toxicities of new treatments for melanoma","volume":"20","author":"Boada","year":"2018","journal-title":"Clin Transl Oncol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"k793","DOI":"10.1136\/bmj.k793","article-title":"Immune-related adverse events for anti-PD-1 and anti-PD-L1 drugs: systematic review and meta-analysis","volume":"360","author":"Baxi","year":"2018","journal-title":"BMJ."},{"key":"B10","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1053\/j.seminoncol.2010.09.007","article-title":"The emerging toxicity profiles of anti-CTLA-4 antibodies across clinical indications","volume":"37","author":"Di Giacomo","year":"2010","journal-title":"Semin Oncol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1038\/nrclinonc.2016.58","article-title":"Safety profiles of anti-CTLA-4 and anti-PD-1 antibodies alone and in combination","volume":"13","author":"Boutros","year":"2016","journal-title":"Nat Rev Clin Oncol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1714","DOI":"10.1200\/JCO.2017.77.6385","article-title":"Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology clinical practice guideline","volume":"36","author":"Brahmer","year":"2018","journal-title":"J Clin Oncol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"2100","DOI":"10.1002\/art.41068","article-title":"Safety and efficacy of immune checkpoint inhibitors in patients with cancer and preexisting autoimmune disease: a nationwide, multicenter cohort study","volume":"71","author":"Tison","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1016\/j.jaad.2013.06.038","article-title":"Pruritus in patients treated with targeted cancer therapies: systematic review and meta-analysis","volume":"69","author":"Ensslin","year":"2013","journal-title":"J Am Acad Dermatol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.det.2018.02.010","article-title":"Pruritus associated with targeted anticancer therapies and their management","volume":"36","author":"Wu","year":"2018","journal-title":"Dermatol Clin."},{"key":"B16","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1097\/CCO.0000000000000290","article-title":"Dermatologic complications of anti-PD-1\/PD-L1 immune checkpoint antibodies","volume":"28","author":"Sibaud","year":"2016","journal-title":"Curr Opin Oncol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1001\/jamadermatol.2018.4560","article-title":"Clinical characterization of immunotherapy-related pruritus among patients seen in 2 oncodermatology clinics","volume":"155","author":"Phillips","year":"2018","journal-title":"JAMA Dermatol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1111\/dth.12027","article-title":"Pruritus to anticancer agents targeting the EGFR, BRAF, and CTLA-4","volume":"26","author":"Fischer","year":"2013","journal-title":"Dermatol Ther."},{"key":"B19","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1001\/jamaoncol.2019.5570","article-title":"Association between immune-related adverse events and recurrence-free survival among patients with stage III melanoma randomized to receive pembrolizumab or placebo: a secondary analysis of a randomized clinical trial","volume":"6","author":"Eggermont","year":"2020","journal-title":"JAMA Oncol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1158\/1078-0432.CCR-15-1136","article-title":"Nivolumab in resected and unresectable metastatic melanoma: characteristics of immune-related adverse events and association with outcomes","volume":"22","author":"Freeman-Keller","year":"2016","journal-title":"Clin Cancer Res."},{"key":"B21","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1007\/s00262-014-1545-8","article-title":"Immunological and biological changes during ipilimumab treatment and their potential correlation with clinical response and survival in patients with advanced melanoma","volume":"63","author":"Simeone","year":"2014","journal-title":"Cancer Immunol Immunother."},{"key":"B22","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1001\/jamadermatol.2015.2707","article-title":"Association of vitiligo with tumor response in patients with metastatic melanoma treated with pembrolizumab","volume":"152","author":"Hua","year":"2016","journal-title":"JAMA Dermatol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/j.jaad.2019.06.035","article-title":"Survival and prognosis of individuals receiving programmed cell death 1 inhibitor with and without immunologic cutaneous adverse events","volume":"82","author":"Chan","year":"2020","journal-title":"J Am Acad Dermatol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/j.annder.2018.01.047","article-title":"Dermatologic toxicities of immune checkpoint inhibitors","volume":"145","author":"Sibaud","year":"2018","journal-title":"Ann Dermatol Venereol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1007\/s40257-017-0336-3","article-title":"Dermatologic reactions to immune checkpoint inhibitors: skin toxicities and immunotherapy","volume":"19","author":"Sibaud","year":"2018","journal-title":"Am J Clin Dermatol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"91","DOI":"10.3389\/fonc.2020.00091","article-title":"Potential immune-related adverse events associated with monotherapy and combination therapy of Ipilimumab, Nivolumab, and Pembrolizumab for advanced melanoma: a systematic review and meta-analysis","volume":"10","author":"Almutairi","year":"2020","journal-title":"Front Oncol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1001\/archderm.142.2.166","article-title":"Skin reactions in a subset of patients with stage IV melanoma treated with anti-cytotoxic T-lymphocyte antigen 4 monoclonal antibody as a single agent","volume":"142","author":"Jaber","year":"2006","journal-title":"Arch Dermatol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1111\/ijd.13540","article-title":"Histopathological aspects of cutaneous erythematous-papular eruptions induced by immune checkpoint inhibitors for the treatment of metastatic melanoma","volume":"56","author":"Perret","year":"2017","journal-title":"Int J Dermatol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1001\/jamadermatol.2018.1912","article-title":"Timing of onset of adverse cutaneous reactions associated with programmed cell death protein 1 inhibitor therapy","volume":"154","author":"Wang","year":"2018","journal-title":"JAMA Dermatol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.632683\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T04:45:21Z","timestamp":1612845921000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.632683\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,9]]},"references-count":29,"alternative-id":["10.3389\/fmed.2021.632683"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2021.632683","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,9]]},"article-number":"632683"}}