Effect of Dermatologic Consultation on Survival in Patients with Checkpoint Inhibitor Associated Cutaneous Toxicity.

BACKGROUND Cutaneous immune-related adverse events (cirAEs) are a common side effect of immune checkpoint inhibitors. However, prior work examining these toxicities in detail has considered only the fraction of events evaluated by dermatologists. Associations between dermatology referral, cirAE treatment, and survival outcomes remain underexplored across care settings. OBJECTIVES To comprehensively categorize cirAE patterns among all patients treated with immunotherapy at our institution, and to evaluate 1) the effect of dermatology referral on cirAE treatment, and 2) the impact of cirAE treatment on survival. METHODS This was a retrospective cohort analysis of cancer patients who initiated ICI therapy between 1/1/16-3/8/19 and developed one or more cirAE, as screened for using ICD-10 codes and confirmed via manual chart review (n=358). All relevant information documented prior to 3/31/20 was included. RESULTS CirAEs evaluated by dermatologists were significantly more likely to be treated than those not referred (OR=6.08, P<0.001). Patients who received any cirAE treatment had improved progression-free survival (HR=0.59, P=0.001) and overall survival (HR=0.58, P=0.007) compared to those who did not. CONCLUSIONS CirAEs evaluated by dermatologists were significantly more likely to be treated than those that were not referred, and patients who received any treatment for cirAE had improved survival outcomes.