Severe cutaneous adverse reactions (SCARs) are associated with high morbidity and mortality in cancer patients. Early identification and treatment of SCARs may improve outcomes.
To identify biomarkers to predict outcomes in hospitalized cancer patients who developed SCARs.
Retrospective review of 144 hospitalized cancer patients with a morbilliform rash, recorded testing for serum cytokines (IL-6, IL-10, and TNF-α) or elafin, and a dermatology consultation. Rashes were categorized as ‘simple’ morbilliform rash without systemic involvement or ‘complex’ morbilliform rash with systemic involvement.
Fifty-four of 144 (37.5%) patients died during follow-up. Elevated levels of IL-6, IL-10, and TNF-α were associated with decreased survival. OS in patients with elevated levels of IL-6, IL-10, and TNF-α was 53.7%, 56.6%, 53.6%, respectively compared to 85.7%, 82.5% and 83.6% with lower levels. Patients with increased levels of both IL-6 and TNF-α had a nearly 6-fold increase in mortality (HR 5.82) compared to patients with lower levels.
Retrospective design, limited sample size, and high-risk population.
Hospitalized cancer patients with rash and elevated IL-6 and TNF-α were nearly 6 times more likely to die over the course of follow-up. These biomarkers may serve as prognostic biomarkers and therapeutic targets for this high-risk population.

Copyright © 2020. Published by Elsevier Inc.