Papers of the Week

The scope of dermatologic adverse events to ibrutinib has not been systemically described. We sought to determine the incidence and severity of ibrutinib-associated dermatologic toxicities and provide management recommendations. We conducted a systematic literature search of clinical trials and cohorts investigating ibrutinib monotherapy for cancer or chronic graft-versus-host disease through June 2020. Thirty-two studies with 2,258 patients were included. The incidence of all-grade toxicities included cutaneous bleeds (24.8%; 95%CI, 18.6%-31.0%), mucocutaneous infections (4.9%; 95%CI, 2.9%-7.0%), rash (10.8%; 95%CI. 6.1% – 15.5%), mucositis (6%; 95%CI, 3.6%-8.5%), edema (15.9%; 95%CI, 11.1%-20.6%), pruritus (4.0%; 95%CI, 0.0%-7.9%), xerosis (9.2%; 95%CI, 5.5%-13.0%), nail changes (17.8%; 95%CI, 4.1%-31.5%), and hair changes (7.9%; 95%CI, 0.0%-21.3%). The incidence of high-grade toxicities included mucocutaneous infection (1.3%; 95%CI, 0.5%-2.2%), rash (0.1%; 95%CI, 0.0%-0.2%), mucositis (0.1%; 95%CI, 0.0%-0.3%), and edema (0.1%; 95%CI, 0.0%-0.2%). It is imperative that clinicians familiarize themselves with ibrutinib-associated dermatologic toxicities to learn how to manage them, prevent discontinuation, and improve patient outcomes.