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.
Carcinoma, Non-Small-Cell Lung , Carcinoma, Renal Cell , Exanthema , Hypopigmentation , Kidney Neoplasms , Lung Neoplasms , Melanoma , Skin Neoplasms , Vitiligo , Humans , Melanoma/drug therapy , Immune Checkpoint Inhibitors/adverse effects , Carcinoma, Non-Small-Cell Lung/drug therapy , Skin Neoplasms/drug therapy , Lung Neoplasms/drug therapy , Exanthema/chemically induced
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.
Communication , Professional-Family Relations , Professional-Patient Relations , Clinical Competence , Health Personnel/organization & administration , Humans , Patient-Centered Care/organization & administration
