Female patients on immune checkpoint inhibitors at risk for dermatologic adverse events

Female patients with melanoma on immune checkpoint inhibitor therapy exhibited higher rates of dermatologic adverse events compared with male patients, according to a study presented at AAD VMX 2021.

Past research minimally explored the risk factors for the development of dermatologic or immune-related adverse events, Jordan T. Said, BA, medical student and researcher at Harvard Medical School, said during the presentation.

Said and colleagues evaluated the impact of sex and menopausal status on the development of dermatologic adverse events in the retrospective single-center cohort study. The cohort included 235 adult patients with metastatic melanoma receiving immune checkpoint inhibitors; 66 of the 93 female patients were postmenopausal. The researchers conducted a multivariate logistic regression analysis controlling for age, type of immune checkpoint inhibitor and number of infusion cycles.

Female patients had a two times higher risk for developing a dermatologic adverse event compared with male patients. Also, comparable risk was exhibited between premenopausal and postmenopausal female patients.

Female patients displayed stronger T cell-dependent immune responses, carrying a higher risk for autoimmune disease compared with male patients, according to the study.

“We know that estrogen can mediate both the activity of regulatory T cells and the PD-1 access, which are involved in the development of both primary autoimmune disease and of immune-related adverse events from checkpoint inhibitors,” Said said. “Clinicians should consider these results in counseling female patients regarding an elevated risk of dermatologic adverse events for immunotherapy.”