Publications by authors named "Lukas Kraehenbuehl"

: Immune-related cutaneous adverse events (ircAEs) are common complications of cancer immunotherapy and provide insight into immune-related adverse events (irAEs) more broadly. To enhance our molecular understanding, we characterized ircAEs resulting from single-agent (PD1) and combined immunotherapy regimens (P+C). Clinically, maculopapular rash (MPR) and toxic epidermal necrolysis (TEN) resemble ircAEs, providing a valuable basis for investigations.

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Purpose: The dermatological management of cancer patients with cutaneous adverse events occurring during and after oncologic treatment is known as supportive oncodermatology. This includes prevention, early identification, and mitigation of dermatologic toxicities. The aim of the international RESCUE (Residents' survey on training of dermatology residents in supportive oncodermatology) study was to ascertain the current level of expertise in supportive oncodermatology among dermatology residents.

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  • Late alopecia, which is incomplete hair regrowth after chemotherapy or endocrine therapy, affects women's quality of life, leading this study to investigate oral minoxidil as a treatment option.
  • The study included 216 patients, primarily women with breast cancer, and found that 74% experienced improvement in hair regrowth after using oral minoxidil for about 3.5 months.
  • Results showed significant increases in hair density on both the frontal and occipital areas, indicating that oral minoxidil is well-tolerated and may help cancer survivors with late alopecia.
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  • Immune-related cutaneous adverse events (ircAEs) affect over 50% of patients on checkpoint inhibitors, yet their mechanisms remain unclear.
  • A study examined 200 patients (139 with ircAEs and 61 controls) to identify clinical presentations and cytokine responses, leading to the discovery of eight different ircAE phenotypes, such as pruritus and eczema, each involving immune cell infiltration.
  • Analysis showed unique cytokine profiles related to specific phenotypes, revealing potential treatment strategies that could involve targeted therapies or corticosteroids for effective management of these adverse events.
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Combined immune checkpoint blockade (ICB) for cancer exhibits good efficacy in a subset of patients but also associates with immune-related adverse events. Xue et al. use an elegant drug screening strategy to identify the antimicrobial drug clofazimine as an agent that both potentiates ICB efficacy and decreases immune-related adverse events.

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  • Immune checkpoint inhibitors (ICIs) and BRAF/MEK inhibitors (BRAF/MEKi) have significantly improved outcomes for advanced melanoma patients in Switzerland, as shown in this study nearly ten years after their introduction.
  • The study analyzed 706 patients from the University Hospital Zurich, with findings that highlighted varying relapse-free survival rates based on treatment type and patient conditions, indicating areas of unmet clinical need.
  • Key results included a median relapse-free survival of 50 months for adjuvant treatments and poor outcomes for patients with aggressive disease features, emphasizing the necessity for ongoing research to improve treatment strategies.
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Recent progress in the treatment of advanced melanoma has led to the improved survival of affected patients. However, novel treatments also lead to considerable and distinct skin toxicity. To further characterize cutaneous adverse events (AE) of systemic treatments, we conducted a single-center retrospective study of biopsy-proven cutaneous adverse events of melanoma treatment over a period of 10 years at the University Hospital of Zurich, Switzerland.

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Immune checkpoint inhibitors (ICI) target the PD-1/PD-L1 and CTLA-4 pathways and allows the immune system to deliver antitumor effects. However, it is also associated with well-documented immune-related cutaneous adverse events (ircAEs), affecting up to 70-90% of patients on ICI. In this study, we describe the characteristics of and patient outcomes with ICI-associated steroid-refractory or steroid-dependent ircAEs treated with dupilumab.

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Cancer immunotherapies, including adoptive T cell transfer, can be ineffective because tumors evolve to display antigen-loss-variant clones. Therapies that activate multiple branches of the immune system may eliminate escape variants. Here, we show that melanoma-specific CD4 T cell therapy in combination with OX40 co-stimulation or CTLA-4 blockade can eradicate melanomas containing antigen escape variants.

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Response to immunotherapies can be variable and unpredictable. Pathology-based phenotyping of tumors into 'hot' and 'cold' is static, relying solely on T-cell infiltration in single-time single-site biopsies, resulting in suboptimal treatment response prediction. Dynamic vascular events (tumor angiogenesis, leukocyte trafficking) within tumor immune microenvironment (TiME) also influence anti-tumor immunity and treatment response.

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Immune-related adverse events (irAEs) frequently complicate treatment with immune checkpoint blockade (ICB) targeting CTLA-4, PD-1, and PD-L1, which are commonly used to treat solid and hematologic malignancies. The skin and gastrointestinal (GI) tract are most frequently affected by irAEs. While extensive efforts to further characterize organ-specific adverse events have contributed to the understanding and management of individual toxicities, investigations into the relationship between multi-organ toxicities have been limited.

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Metastatic uveal melanoma (UM) remains challenging to treat, with objective response rates to immune checkpoint blockade (ICB) being much lower than in primary cutaneous melanoma (CM). Besides a lower mutational burden, the overall immune-excluded tumor microenvironment of UM might contribute to the poor response rate. We therefore aimed at targeting deficiency in argininosuccinate synthase 1, which is a key metabolic feature of UM.

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  • Patients with prostate cancer treated with apalutamide often experience dermatological adverse events (dAEs), with a notable frequency of rashes and skin issues.
  • A study of 303 patients revealed that 23.4% developed dAEs, most commonly maculopapular rashes and xerosis, typically occurring around 77 days after treatment initiation.
  • Management primarily involved topical and oral steroids, with clinical trial participants being more likely to report dAEs, especially those also receiving abiraterone/prednisone.
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Background And Aims: This experimental study assesses the influence of different gases and insufflation pressures on the portal, central-venous and peripheral-arterial pH during experimental laparoscopy.

Methods: Firstly, 36 male WAG/Rij rats were randomized into six groups (n = 6) spontaneously breathing during anaesthesia: laparoscopy using carbon dioxide or helium at 6 and 12 mmHg, gasless laparoscopy and laparotomy. 45 and 90 min after setup, blood was sampled from the portal vein, vena cava and the common femoral artery with immediate blood gas analysis.

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The discovery and clinical implementation of immune-checkpoint inhibitors (ICIs) targeting CTLA4, PD-1 and PD-L1 has revolutionized the treatment of cancer, as recognized by the 2018 Nobel Prize for Medicine and Physiology. This groundbreaking new approach has improved the outcomes of patients with various forms of advanced-stage cancer; however, the majority of patients receiving these therapies, even in combination, do not derive clinical benefit. Further development of agents targeting additional immune checkpoints, co-stimulatory receptors and/or co-inhibitory receptors that control T cell function is therefore critical.

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  • Checkpoint inhibitors (CPIs) are effective cancer treatments that can lead to long-lasting remissions but often cause serious autoimmune side effects.
  • This review explores the mechanisms of how CPIs, specifically targeting CTLA4 and PD-1/PD-L1, work at cellular and molecular levels to enhance immune responses against tumors.
  • Understanding the complex functions of these immune checkpoints is crucial for creating new strategies to maximize the benefits of CPIs while minimizing their negative side effects.
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Objective: To familiarize the reader with the most common cutaneous adverse events with immune checkpoint inhibitors (CPIs) and their grading and treatment.

Data Sources: Recent research articles, relevant review articles, and case series/reports in English from the PubMed database mostly, from 2010 onward.

Study Selections: Most data are from retrospective studies and case series.

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