Common toxicities associated with immune checkpoint inhibitors and targeted therapy in the treatment of melanoma: A systematic scoping review

• Published in: Critical reviews in oncology/hematology 2023-03, Vol.183, p.103919-103919, Article 103919
• Main Authors: Egeler, Mees D., van Leeuwen, Marieke, Fraterman, Itske, van den Heuvel, Noelle M.J., Boekhout, Annelies H., Lai-Kwon, Julia, Wilthagen, Erica A., Eriksson, Hanna, Haanen, John B., Wilgenhof, Sofie, Ascierto, Paolo A., van Akkooi, Alexander C.J., van de Poll-Franse, Lonneke V.
• Format: Article
• Language: English
• Subjects: Adverse events; Antineoplastic Agents, Immunological - therapeutic use; Humans; Immune Checkpoint Inhibitors; Immune Checkpoint Inhibitors - therapeutic use; Immunotherapy; Medicin och hälsovetenskap; Melanoma; Melanoma - drug therapy; Syndrome; Targeted therapy; Toxicities
• ISSN: 1040-8428; 1879-0461; 1879-0461
• DOI: 10.1016/j.critrevonc.2023.103919

This systematic scoping review compares the toxicities experienced by patients receiving immune checkpoint inhibitors (ICIs) or targeted therapy (TT) for stage III (resected and unresectable) and stage IV melanoma. OVID Medline, Embase, and PsycInfo were searched to identify Phase III trials reporting toxicities of FDA-approved ICIs and TT for advanced melanoma. AEs that were reported by ≥ 10% of patients in the evaluated trials were included. Toxicity profiles of 11208 patients from 24 studies were reviewed. The rate of AEs was lower with ICIs compared to TT. However, ICIs were associated with higher rates of long-term or permanent AEs compared to TT, where toxicities generally were shortterm and reversible with treatment discontinuation. The toxicity profiles of ICIs and TT vary substantially. Whilst the rate of AEs was lower with ICIs than during TT, it was also associated with higher rates of potentially chronic AEs. •The use of targeted therapy (TT) was associated with higher rates of AEs than the use of immune-checkpoint inhibitors (ICIs).•ICIs were associated with higher rates of long-term AEs compared to TT, where toxicities were short-term and reversible.•Resected melanoma patients experienced more AEs during ICIs than unresectable or metastatic melanoma patients.•For TT, vemurafenib was associated with the highest rates of AEs of all evaluated mono and combination treatments.•Varying toxicity reporting methods are a serious problem when comparing toxicity results from melanoma trials.