Skin Toxicity Induced by Chemotherapy or Molecular Targeted Therapy Combined with Immune Checkpoint Inhibitors in Asian Patients: A Literature Review by the Japanese Pharmacist-Led Oncodermatology Study Team
April 2026
in “
International Journal of Clinical Oncology
”
immune checkpoint inhibitors chemotherapy molecularly targeted therapy capecitabine hand-foot syndrome multikinase inhibitors hand-foot skin reaction taxane alopecia EGFR inhibitors skin toxicities inflammatory pathways immune cell recruitment ICIs HFS HFSR epidermal growth factor receptor inhibitors
TLDR Combining immune checkpoint inhibitors with other cancer therapies increases skin side effects in Asian patients.
The review by the Japanese Pharmacist-led Oncodermatology Study Team highlights that combining immune checkpoint inhibitors (ICIs) with chemotherapy or molecularly targeted therapy can exacerbate skin toxicities in Asian patients. Analyzing 28 studies out of 7,287 articles, the review focuses on capecitabine-induced hand-foot syndrome (HFS), multikinase inhibitor-induced hand-foot skin reaction (HFSR), taxane-induced alopecia, and EGFR inhibitor-related skin toxicities. The addition of ICIs was associated with a higher incidence of these skin toxicities, particularly capecitabine-related HFS and EGFR inhibitor-related skin issues. The findings emphasize the need for careful monitoring and management strategies to address these dermatologic side effects in combination therapies, as ICIs, while improving cancer survival rates, can amplify drug-specific skin toxicities through shared inflammatory pathways and immune cell recruitment to the skin. The study suggests that ICIs may enhance immune activity, potentially exacerbating skin toxicities, and highlights the need for preventive strategies and tailored treatment approaches for Asian populations.
