Sanmartin-Jiménez, O. (Onofre)

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    Clinical management of cutaneous adverse events in patients on targeted anticancer therapies and immunotherapies: a national consensus statement by the Spanish Academy of Dermatology and Venereology and the Spanish Society of Medical Oncology
    (Springer Science and Business Media LLC, 2019) Botella-Estrada, R. (Rafael); Segura, S. (S.); España, A. (Agustín); Sanmartin-Jiménez, O. (Onofre); Suh-Oh, H.J. (H. J.); Gurpide, A. (Alfonso); Beato, C. (C.); Majem-Tarruella, M. (Margarita); Aragón, I. (I.); Grávalos, C. (C.)
    Progress in the understanding of many tumors has enabled the development of new therapies, such as those targeted at specific molecules involved in cell growth (targeted therapies) or intended to modulate the immune system (immunotherapy). However, along with the clinical benefit provided by these new treatments, new adverse effects have also appeared. Dermatological toxicities such as papulopustular eruptions, xerosis, and pruritus are common with EGFR inhibitors. Other adverse effects have also been described with PDGFR, BCR-ABL, and MAPK tyrosine kinase inhibitors, antiangiogenic drugs, and inhibitors at immune checkpoints such as CTLA-4 and PD-1/PD-L1. Onset of these adverse effects often causes dose reductions and/or delays in administering the prescribed therapy, which can affect patient survival and quality of life. It is, therefore, important to prevent the occurrence of these adverse effects, or to treat unavoidable ones as soon as possible. This requires cooperation between medical oncologists and dermatologists. This article reviews the various dermatological toxicities associated with targeted therapies and immunotherapies, along with their diagnosis and therapeutic management.
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    Risk factors and rate of recurrence after Mohs surgery in basal cell and squamous cell carcinomas: a nationwide prospective cohort (REGESMOHS, Spanish Registry of Mohs Surgery)
    (Society for the Publication of Acta Dermato-Venereologica, 2021) Cano-Martínez, N. (Natividad); Ruiz-Salas, V. (Verónica); Toll-Abelló, A. (Agustí); Sanchez-Schmidt, J.M. (Julia M.); Botella-Estrada, R. (Rafael); Vilarrasa-Rull, E. (Eva); Alfaro-Rubio, A. ( Alberto); Sánchez-Sambucety, P. (Pedro); Tomás-Velázquez, A. (Alejandra); Vázquez-Veiga, H. (Hugo); Artola-Igarza, J.L. (Juan L.); Descalzo, M.A. (Miguel A.); García-Bracamonte, B. (Beatriz); Miñano-Medrano, R. (Román); Delgado-Jiménez, Y. (Yolanda); Gil-Sanchez, M.P. (María Pilar); Mayor-Arenal, M. (Matías); Sanmartin-Jiménez, O. (Onofre); Sainz-Gaspar, L. (Laura); Cueva-Dobao, P. (Pablo) de la; García-Doval, I. (Ignacio); Gonzalez-Sixto, B.(Beatriz); Navarro-Tejedor, R. (Raquel); Flórez-Menéndez, A. (Ángeles); González, L. (Lucía); Eusebio-Murillo, E. (Esther) de; Ocerin-Guerra, I. (Izascun); Suárez-Fernández, R. (Ricardo); Rodríguez-Prieto, M.A. (Manuel A.); Ciudad-Blanco, C. (Cristina); Allende-Markixana, I. (Irati); Lopez-Estebaranz, J.L. (J. L.); Martorell-Calatayud, A. (Antonio); Redondo-Bellón, P. (Pedro); Garcés, J.R. (Joan R.); Escutia-Muñoz, B. (Begoña); Morales-Gordillo, V. (Victoriano); Alonso-Pacheco, L. (L.)
    Randomized studies to assess the efficacy of Mohs micrographic surgery in basal cell and squamous cell carcinomas are limited by methodological and ethical issues and a lack of long follow-up periods. This study presents the "real-life" results of a nationwide 7-years cohort on basal cell carcinoma and squamous cell carcinoma treated with Mohs micrographic surgery. A prospective cohort was conducted in 22 Spanish centres (from July 2013 to February 2020) and a multivariate analysis, including characteristics of patients, tumours, surgeries and follow-up, was performed. A total of 4,402 patients followed up for 12,111 patient-years for basal cell carcinoma, and 371 patients with 915 patient-years of follow-up for squamous cell carcinoma were recruited. Risk factors for recurrence included age, non-primary tumours and more stages or unfinished surgeries for both tumours, and immunosuppression for squamous cell carcinoma. Incidence rates of recurrence were 1.3 per 100 person-years for basal cell carcinoma (95% confidence interval 1.1-1.5) and 4.5 for squamous cell carcinoma (95% confidence interval 3.3-6.1), being constant over time (0-5 years). In conclusion, follow-up strategies should be equally intense for at least the first 5 years, with special attention paid to squamous cell carcinoma (especially in immunosuppressed patients), elderly patients, non-primary tumours, and those procedures requiring more stages, or unfinished surgeries.