Williams Cancer Institute

Skin rash/itching

Skin rash/itching

Skin rashes and itching may not seem like a major problem, but it can be extremely distressing and annoying for patients. Commonly, if this is in a small localized area, steroid creams can be fairly effective. Using antihistamines can also be helpful. However, the associated itching, especially over a larger area of the body can really be a problem when it does not respond to these conservative treatments. I want to share something that we have had success with, most typically inpatients on systemic PD-1/PD-L1 inhibitors. A publication by Ito, et al., in Lung Cancer, July 2017 titled “Aprepitant for Refractory Nivolumab-induced Pruritus” describes how aprepitant (Emend), an oral neurokinin-1 receptor antagonist was useful in a case report. We have also used this with fairly good success as well. This medicine is normally used for the prevention of chemotherapy-induced nausea and vomiting. The medication can be fairly expensive if not covered by insurance. Generally it only needs to be used for 3-5 days to have effect. So if you are having issues with itching that are not responding to other treatments, it may be wise to suggest this to your doctor. I would recommend that you show them the above article, which you can find the summary of on the Internet.

Reference: Jason R. Williams, 15 Oct 2019, The Immunotherapy Revolution: The Best New Hope For Saving Cancer Patients’ Lives, https://williamscancerinstitute.com/the-immunotherapy-revolution

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