TOPLINE:

In a retrospective analysis, immune-related pruritus (irPruritus) affected nearly one quarter of patients with metastatic melanoma undergoing immune checkpoint inhibitor (ICI) therapy, with combination therapy showing a higher incidence than monotherapy.

METHODOLOGY:

• Researchers conducted a retrospective, monocentric cohort study analysing clinical data of 461 patients with metastatic melanoma (mean age, 62.6 years; 61.6% men) treated at a tertiary academic cancer centre between 2014 and 2022.
• Patients with metastatic melanoma received ICIs as either combination therapy with ipilimumab and nivolumab (114 patients) or monotherapy with nivolumab (148 patients) or pembrolizumab (199 patients).
• Researchers evaluated the association between ICI administration and the occurrence of irPruritus following the initiation of therapy and analysed the clinical course and correlation with treatment response including overall survival.
• Eosinophil counts were measured at baseline before the initiation of treatment and at the onset of irPruritus, with the severity of irPruritus and immune-related rash assessed using Common Terminology Criteria for Adverse Events staging.

TAKEAWAY:

• irPruritus occurred in 23.0% of all patients (106/461), with the prevalence differing by treatment regimen: 31.6% with ipilimumab and nivolumab combination therapy, 22.1% with pembrolizumab monotherapy, and 17.6% with nivolumab monotherapy (P = .03).
• Combination therapy resulted in an earlier onset of irPruritus, occurring after a mean of 1.6 infusions compared to 7.4 infusions with pembrolizumab and 8.8 infusions with nivolumab (P < .001).
• Eosinophil counts increased from 2.3% at baseline to 4.2% at the onset of symptoms in patients with irPruritus, showing a more pronounced elevation than those without irPruritus (P < .001 for each group).
• irPruritus demonstrated a significant correlation with immune-related fatigue (P < .001) and immune-related rash (P < .01), with 69.2% of patients with irPruritus developing immune-related rash and 32.1% experiencing immune-related fatigue. Topical corticosteroids were effective in 90.9% of patients.

IN PRACTICE:

"[The study] findings highlight the importance of systematic clinical follow-up in patients receiving ICl-based cancer therapy, enabling earlier and more individualized interventions to maintain both ICI treatment and patients' quality of life," the authors wrote.

SOURCE:

This study was led by Andrea Roggo, Department of Dermatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland. It was published online on March 25, 2026, in Journal der Deutschen Dermatologischen Gesellschaft.

LIMITATIONS:

The study had a monocentric and retrospective design.

DISCLOSURES:

No funding information was provided for the study. Two authors reported receiving unrelated research support and having other ties with Roche, Novartis, Amgen, and various other sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.