Cutaneous immune-related Adverse Events, anti-melanoma drugs and survival

The JAAD has recently published our paper describing the cutaneous immune-related adverse events (irAE) that appear with anti-PD1 monoclonal antibodies (pembrolizumab or nivolumab). These molecules do not create the dramatic changes in melanoma metastasis that BRAF inhibitors show, but it seems to create more sustained responses. Moreover, they are the most effective treatment for patients that do not have the V600E mutation in the BRAF gene (50-60% of the metastatic melanoma patients). The treatment of melanoma and metastatic melanoma in particular keeps changing, and we are glad we are part of it, helping to make doctors familiar with the cutaneous side effects of these medications and, hopefully, facilitating the treatment of these patients, as most side effects are easily managed by dermatologists and do not require reduction or cessation of the medication.
Another important topic is the possible association between the development of irAE and survival. In our paper, we didn’t have enough sample size and time on treatment to calculate this. Some other authors have tried with different success. In fact, the statistical analysis require to confirm this association is quite complex, and we talk about it in this letter in JAMA Dermatology. As there is enough indirect data to suggest that this could be the case, we are working hard to present our results soon.