Biologic Treatment for Cutaneous Immune-Related Adverse Events in Cancer Patients Undergoing Immune-Checkpoint Therapy: A Retrospective Review

Cutaneous immune-related adverse events (cirAEs) from immune checkpoint inhibitor (ICI) therapy can disrupt the course of oncology treatment. Data guiding the safety and effectiveness of biologic agents for cirAEs remain limited. We therefore aimed evaluate the efficacy and oncologic safety of biologic therapy for ICI-associated cirAEs. We conducted a retrospective chart review of adult patients at Beth Israel Deaconess Medical Center from January 1 st 2015 to July 31 st 2025 who received biologic therapy from a dermatologist for a cirAE while on immunotherapy for a malignancy. We collected demographics, cirAE phenotype, biologic used, cirAE outcomes, ICI treatment course, and cancer status before and after biologic initiation. Twenty-two patients with 30 discrete cirAEs were included. The most common cirAE phenotypes were psoriasiform (36%), immunobullous (29%), and eczematous (26%) erupitons. Overall, 19/22 patients (86%) achieved complete resolution of their cirAE on biologic therapy. Among patients whose ICIs were held or discontinued, 6/18 (33%) successfully resumed immunotherapy after cutaneous improvement on a biologic. No patient experienced a change in cancer status from before to after biologic treatment. Our findings suggest that biologic medications are highly effective for treating a range of ICI-induced cirAEs. Furthermore, their use appears safe in this population, with no adverse impact on cancer status. Biologic therapy may allow for the salvage of ICI treatment in a subset of patients, potentially improving overall cancer outcomes.