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1.
Ann Oncol ; 32(6): 736-745, 2021 06.
Article in English | MEDLINE | ID: mdl-33667669

ABSTRACT

BACKGROUND: Immunoglobulin E (IgE) blockade with omalizumab has demonstrated clinical benefit in pruritus-associated dermatoses (e.g. atopic dermatitis, bullous pemphigoid, urticaria). In oncology, pruritus-associated cutaneous adverse events (paCAEs) are frequent with immune checkpoint inhibitors (CPIs) and targeted anti-human epidermal growth factor receptor 2 (HER2) therapies. Thus, we sought to evaluate the efficacy and safety of IgE blockade with omalizumab in cancer patients with refractory paCAEs related to CPIs and anti-HER2 agents. PATIENTS AND METHODS: Patients included in this multicenter retrospective analysis received monthly subcutaneous injections of omalizumab for CPI or anti-HER2 therapy-related grade 2/3 pruritus that was refractory to topical corticosteroids plus at least one additional systemic intervention. To assess clinical response to omalizumab, we used the Common Terminology Criteria for Adverse Events version 5.0. The primary endpoint was defined as reduction in the severity of paCAEs to grade 1/0. RESULTS: A total of 34 patients (50% female, median age 67.5 years) received omalizumab for cancer therapy-related paCAEs (71% CPIs; 29% anti-HER2). All had solid tumors (29% breast, 29% genitourinary, 15% lung, 26% other), and most (n = 18, 64%) presented with an urticarial phenotype. In total 28 of 34 (82%) patients responded to omalizumab. The proportion of patients receiving oral corticosteroids as supportive treatment for management of paCAEs decreased with IgE blockade, from 50% to 9% (P < 0.001). Ten of 32 (31%) patients had interruption of oncologic therapy due to skin toxicity; four of six (67%) were successfully rechallenged following omalizumab. There were no reports of anaphylaxis or hypersensitivity reactions related to omalizumab. CONCLUSIONS: IgE blockade with omalizumab demonstrated clinical efficacy and was well tolerated in cancer patients with pruritus related to CPIs and anti-HER2 therapies.


Subject(s)
Immunoglobulin E , Omalizumab , Aged , Female , Humans , Immune Checkpoint Inhibitors , Male , Omalizumab/adverse effects , Pruritus/chemically induced , Pruritus/drug therapy , Retrospective Studies
3.
J Clin Neurosci ; 5(3): 353-6, 1998 Jul.
Article in English | MEDLINE | ID: mdl-18639049

ABSTRACT

Approximately 300 cases of primary meningeal melanoma have been reported in the literature;(1) eight of these cases had an associated pineal melanoma without additional parenchymal lesions.(2) We present another such case and demonstrate the advantage of magnetic resonance imaging over computed tomography in the early detection of meningeal involvement.

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