BI08 A prospective observational study exploring the incidence and impact of cutaneous toxicities in patients undergoing oncological treatment

Abstract Patients with cancer develop a wide range of skin toxicities, which often limit treatments and impact quality of life (QoL). Ireland has yet to develop a national database of cutaneous toxicities resulting from oncological treatments. A pilot oncodermatology fellowship was established at a tertiary centre to address the dermatological needs of oncology patients, in addition to undertaking a prospective study to quantify the incidence and impact of cutaneous adverse events in this cohort. A daily oncodermatology consult service was established. Patients were reviewed, treatment was advised and data regarding patient characteristics and QoL were obtained. Inclusion criteria were age > 18 years, being on oncological treatment, and having a suspected cutaneous toxicity. Patients were excluded if they did not or could not consent. Data were collected prospectively on the REDCap electronic database. Data from October 2023 to December 2024 are included. In total, 92 patients were reviewed by the oncodermatology consult service. Of these, 59 had side-effects of cancer treatment. Their mean age was 66 years. Overall, 89 patients were seen on the same day as the consult request. The most common referral reason was ‘rash’ (47%). The most common underlying malignancies were melanoma (18%) and lung cancer (16%). The median duration of the dermatological condition was 28 days (range 1–1095). Cutaneous toxicities were most common in patients on immunotherapy only (39%), followed by patients on targeted therapy only (25%). The most frequently observed immunotherapy agent causing cutaneous toxicity was pembrolizumab (20%). Cetuximab and bevacizumab were the most common culprit targeted therapies (both 7%). The most common dermatological diagnoses made were psoriasiform rash (19%) and lichenoid eruption (17%). There were two severe cutaneous reactions: one case of drug reaction with eosinophilia and systemic symptoms and one case of Stevens–Johnson syndrome. The most commonly recommended treatment was topical corticosteroid (75%). Most patients (73%) did not require a change to the their treatment regimen, 19% had their treatment held, 3% were changed to alternate treatment and 5% had oncological treatment ceased. Patients completed the Dermatology Life Quality Index (DLQI), the National Comprehensive Cancer Network (NCCN) distress scale and the Kessler Psychological distress scale (K10). In total, 20% of patients reported a high impact on QoL (DLQI), 17% were deemed likely to have a mental health disorder (K10) and 87% reported distress using the NCCN thermometer. These data demonstrate the need for a dedicated oncodermatology service in order to limit unnecessary treatment breaks or dose reductions. Cutaneous toxicities may impact on QoL. Decisions regarding alterations to treatment plans due to cutaneous toxicities should be made in collaboration by oncologists and dermatologist.