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TOPLINE:

Patients with antibody-drug conjugate (ADC)-related skin reactions had higher response rates and fewer treatment discontinuations when treated with dupilumab than with systemic steroids.

METHODOLOGY:

• Researchers evaluated 163 patients at Memorial Sloan Kettering Cancer Center who received an ADC from January 2020 through September 2024, with follow-up until December 2024.
• The analysis included 27 adult patients with ADC-induced dermatologic adverse events (dAEs); 11 were treated with dupilumab (63.6% women; 81.8% White) and 16 were treated with systemic steroids alone (37.5% women; 81.2% White).
• Researchers analyzed the severity of dAEs, treatment responses, and cancer treatment discontinuation rates.

TAKEAWAY:

• In the dupilumab group, 82% of patients received enfortumab vedotin for genitourinary malignancies, and 46% received pembrolizumab. Clinical presentations of dAEs included eczematous eruptions in 54% of patients, morbilliform eruptions in 46%, and vesiculobullous eruptions in 27%.
• In the steroid-treated group, all patients received enfortumab vedotin with pembrolizumab for genitourinary malignancies. In the dupilumab group, 70% of patients experienced grade 3 events, whereas 56% in the steroid-only group experienced grade 2 reactions.
• In the dupilumab group vs the steroid-only group, 73% vs 56% of patients achieved complete response, and 27% vs 25% achieved partial response of skin reactions, respectively. Among those on dupilumab, the median time to first clinical response was 24 days, and the median time to best clinical response was 52 days.
• In the dupilumab group, no patients discontinued treatment because of dAEs vs 43.8% in the steroid-only group (P < .05).

IN PRACTICE:

“Dupilumab appears promising as a steroid-sparing treatment of ADC-induced cutaneous toxicities,” which “are difficult to manage and can disrupt cancer treatment,” the study authors wrote. “Further research is essential to explore its broader utility and economic feasibility,” they added.

SOURCE:

The study was led by Ian Nykaza, BS, of the Dermatology Service, Department of Medicine at Memorial Sloan Kettering Cancer Center, New York City. It was published online on July 30 in JAMA Dermatology.

LIMITATIONS:

Limitations included the small study size, retrospective design, treatment heterogeneity, and limited ADC diversity.

DISCLOSURES:

This study was supported by the National Institutes of Health/National Cancer Institute’s Cancer Center Support Grant P30 CA008748. Several authors reported receiving personal fees and research funding from various sources.

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