Study Characterizes Skin Toxicity With Uveal Melanoma Rx

TOPLINE:

Nearly 80% of patients with metastatic uveal melanoma experienced skin toxicities with tebentafusp, a targeted immunotherapy, according to a study that also suggests that the presence of skin reactions is associated with improved survival.

METHODOLOGY:

• This prospective cohort study evaluated 33 patients with metastatic uveal melanoma who were treated with tebentafusp (Kimmtrak) at the University Hospital of Ludwig Maximilian University (LMU) Munich, Munich, Germany, from January 2019 to June 2023.
• Patients were hospitalized for the first three doses and observed for at least 16 hours, with a 7-day interval between doses.
• Researchers noted skin toxicities and performed skin biopsies.
• The median follow-up was longer in patients with skin toxicity (21.5 months) than in those without any skin symptoms (3 months).

TAKEAWAY:

• Skin toxicity was observed in 78.8% of the patients treated with tebentafusp; researchers noted 68 skin eruptions after 105 doses, most commonly on the face and torso.
• Skin eruptions were classified into four categories: Symmetrical erythematous patches on the face, neck, trunk, and/or arms (83.8%); hemorrhagic macules on the distal portion of the upper or lower extremities (11.8%); urticarial lesions (7.4%); and bullous lesions (1.5%). Depigmentation of skin (8.5%) and hair (11.4%) was also reported.
• Skin biopsies revealed mild lymphocytic infiltration with focal dermatitis and, in more severe cases, subepidermal detachment and mixed immune cell infiltrates.
• All seven patients without skin symptoms died during follow-up compared with eight (31%) of those with skin toxicity. The group with skin toxicity had a significantly longer median overall survival than the group without skin symptoms (34 vs 4 months; P = .001).

IN PRACTICE:

Tebentafusp is approved for the treatment of uveal melanoma and “is currently being investigated for advanced cutaneous melanoma and might be applied more frequently in the future; therefore, knowledge and understanding of the pathogenesis of the tebentafusp associated rash will be crucial for the treating oncologists and dermatologists,” the authors wrote.

SOURCE:

The study was led by Dirk Tomsitz, MD, of the Department of Dermatology and Allergy, LMU University Hospital Munich, and was published online on August 28 in the Journal of the American Academy of Dermatology.

LIMITATIONS:

This study is limited by its single-center design and small sample size.

DISCLOSURES:

This work was funded by the German Federal Ministry of Education and Research. Tomsitz and two other authors disclosed receiving consultancy, speaker fees, research funding, or travel grants from several pharmaceutical companies.

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