Cecilia Tejero-García, Francesc Alamon Reig, Xavier Bosch‐Amate, Cristina Carrera, Priscila Giavedoni, Inmaculada Gil Faure, Alicia Jiménez Antón, Ander Mayor Ibarguren, Teresa Usero Bárcena, Marcial Álvarez‐Salafranca, Marta Gamissans Cañada, J. López Robles, Sandra Martínez‐Fernández, Sònia Segura, Dolores Sánchez‐Aguilar Rojas, Ángeles Flórez
Immune checkpoint inhibitors (ICIs) have signifi-cantly improved oncologiconcological outcomes. However, ICIs can elicit immune-mediated adverse effects that may require treatment discontinuation and potentially affect cancer prognosis. Bullous pemphigoid (BP) can be induced by ICIs in up to 1 % of treated patients. Conventional treatments for BP (topical and systemic glucocorticoids as well as other classical immunosuppressants) associate substantial toxicities and may impair antitumour responses. Dupilumab, a monoclonal antibody that blocks IL-4/IL-13 signalling, represents a promising alternative, offering effective disease control with an improved safety profile. In this study, we assessed the efficacy and safety of dupilumab for the treatment of ICI-induced BP (ICI-BP) in a real-world multicentre case series of 19 patients, an underreported clinical setting. The median time to ICI-BP development from ICI initiation was 390 days (IQR 295). Overall, 18 patients (94.74%) achieved a clinical response, of whom 16 (84.21%) attained complete remission. Disease stabilization was observed in one1 patient. Among 17 patients receiving systemic corticosteroids prior to dupilumab, 14 (82.35%) discontinued them afterwards. Additionally, 11 patients (61.11 %; n=18) were able to continue or reintroduce ICI after dupilumab initiation. Dupilumab was well tolerated, with 18 patients (94.74%) experiencing no significant adverse events and only one case of suspected psoriasiform toxicity.