Immune Checkpoint Inhibitor-Induced Dermatitis
Conditions
Keywords
refractory immune checkpoint inhibitors (ICI)-related dermatitis, Solid Malignant Tumor, JAK inhibitors
Brief summary
Currently, the principal strategy for immune checkpoint inhibitors (ICI)-related dermatitis include systemic use of corticosteroids, which can impair the efficacy of preceding ICIs treatment. Janus kinase inhibitors (JAKi) could be the optimal option for ICI-related dermatitis, which can not only provide rapid relief for ICI-related dermatitis but also potentially enhance the anti-tumor efficacy of ICIs with minimal adverse events. This is an open-lable, phase II trial, aims to evaluate efficacy and safety of JAK inhibitors for solid malignant tumor patients with refractory ICI-related dermatitis.
Interventions
DRUGtreated with JAK inhibitors orally for 28 days
treated with JAK inhibitors (upadacitinib 15mg qd/tofacitinib 5mg bid)orally for 28 days
Sponsors
Shixiu Wu
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Must be at least 18 years of age 2. Clinical diagnosis of solid malignant tumor. 3. Patients who have received treatment with any Food and Drug Administration (FDA)-approved monoclonal antibodies targeting CTLA-4, PD-1, or PD-L1, either as monotherapy or in combination. 4. Clinical diagnosis of Immune checkpoint inhibitors (ICI)-related dermatitis graded as 3-4 5. Patients with ICI-related dermatitis who were refractory to previous treatment with corticosteroids and/or immunosuppressive agents. 6. Adequate bone marrow and organ function, as outlined below, must be confirmed: 1\) White blood cell (WBC) count ≥ 2.0 × 10⁹/L 2) Absolute neutrophil count (ANC) ≥ 1.5 × 10⁹/L 3) Platelet count (PLT) ≥ 75 × 10⁹/L 4) Hemoglobin (Hgb) ≥ 90 g/L 5) AST and ALT ≤ 3 × upper limit of normal (ULN) in patients without hepatic metastases; ≤ 5 × ULN in those with hepatic metastases, provided the elevation is not attributable to ICI-related hepatitis 6) Total bilirubin ≤ 2 × ULN, except in cases of Gilbert's syndrome (where total bilirubin must be \< 3.0 mg/dL), and not due to ICI-related hepatotoxicity 6. All participants must be capable of providing personally signed and dated informed consent, demonstrating understanding of all relevant study aspects.
Exclusion criteria
1. Clinical diagnosis of dermatological diseases (e.g., chronic inflammatory skin disorders such as atopic dermatitis or psoriasis) that, in the investigator's assessment, may elevate the risks associated with study participation or compromise the interpretation of study outcomes. 2. Female who is pregnant, breastfeeding, or considering pregnancy during the study. 3. Current or past history of infection including herpes zoster or herpes simplex, human immunodeficiency virus (HIV), active Tuberculosis, active or chronic recurring infection, active hepatitis B or C. 4. Patients with ICI-related dermatitis who were either treatment-naïve (having received no prior steroids or immunosuppressants) 5. Any other medical, psychiatric, or logistical condition that, in the judgment of the investigator, could pose a safety risk, affect protocol compliance, or interfere with the conduct or interpretability of the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Explore the efficacy of JAK inhibitors in adult patients with refractory ICI-related dermatitis. | At the end of treatment at day 28 | The efficacy evaluated by the proportion of patients with rashes relief (defined as ICI-related dermatitis grade ≤1according to CTCAE v5.0, ) |
| Evaluate the safety of JAK inhibitors in adult patients with refractory ICI-related dermatitis | During the period of medication（28 days） and follow-up（2 months after discontinuation of the drug） | The safty will be assessed based on the incidence and severity of adverse events (AEs) and serious adverse events (SAEs) during upadacitinib treatment. The severity of AEs will be graded using NCI CTCAE v5.0. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The change of pruritus severity | From enrollment to the end of treatment at 28 days | Pruritus severity assessed by the time to achieve a 4-point improvement on the Peak Pruritus Numerical Rating Scale (PP-NRS) |
| Explore the proportion of continued ICIs utilization at the end of JAK inhibitors treatment | At the end of treatment at day 28 | — |
Countries
China
Contacts
CONTACTShixiu Wu, MD
Outcome results
None listed