RESUMO
BACKGROUND: Cutaneous adverse events (CAEs) related to oncological therapies are a common scenario in daily clinical practice. METHODS: This is a retrospective observational study collecting the data regarding CAEs of patients treated with immune checkpoints inhibitors (ICIs) in four different Italian centers. RESULTS: Of 323 patients included, 305 were evaluable for this analysis; 182 patients (59.7%) had metastatic cutaneous melanoma (CM), 99 (32.5%) non-small cell lung cancer (NSCLC) and 24 (7.8%) renal cell carcinoma (RCC). The most frequent CAEs that we found, considering all the 305 patients, were pruriginous maculopapular rash (10.2% of the patients), vitiligo-like areas (7.2% of the patients), psoriasiform rash (6.2% of the patients), asymptomatic maculopapular rash (4.6% of the patients), and lichenoid rash (4.3% of the patients). Vitiligo-like areas occurred more frequently in patients with CM, while a lichenoid rash was more frequently observed in patients with RCC. Treatment interruption was related to drug-induced CAEs in 15.4% of melanoma patients and 0.0% of lung and kidney patients. Patients developing a cutaneous adverse event had better overall response rate and higher progression free survival and overall survival than the patients without CAEs. CONCLUSIONS: Our study brings new information on the characteristics of CAEs related to ICIs treatment in three different types of cancers, CM, NSCLC and RCC.
Assuntos
Carcinoma Pulmonar de Células não Pequenas , Carcinoma de Células Renais , Exantema , Hipopigmentação , Neoplasias Renais , Neoplasias Pulmonares , Melanoma , Neoplasias Cutâneas , Vitiligo , Humanos , Melanoma/tratamento farmacológico , Inibidores de Checkpoint Imunológico/efeitos adversos , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Exantema/induzido quimicamenteRESUMO
Nowadays the healthcare provider is asked to be able to cope with "difficult communications" with cronical disease patients and families, concerning both diagnosis report and manage the disease critical stages. It's therefore needed a training which does not only privileges clinical practice but also our capacity to reflect on our daily actions and the awareness of words' impact. In order to be able to move from a disease centred to patient centred take in charge, narrative skills and wise choice of words are fundamental to sympathize with the patient, with his/her experience, his/her beliefs and expectations so to build shared and above all sustainable treatment paths.
