Nivolumab-associated Stevens-Johnson syndrome in a patient with lung cancer

Gracia‐Cazaña, Tamara; Padgett, Esteban; Calderero, V.; Oncíns, Rosa

doi:10.5070/d3273052777

Cited by 11 publications

(11 citation statements)

References 9 publications

(12 reference statements)

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“…Seven cases were SJS, while TEN was diagnosed in three cases [12,13,15], and one case was an SJS/TEN overlap in keeping with our reported patient [17]. SJS/TEN rash onset ranged from 1 week [16,20] to 4 months [14] with an average latency of 2 -4 weeks. Interestingly, in the latter case [14], SJS rash appeared after eight cycles of nivolumab therapy in a similar pattern of delayed autoimmune diseases [14].…”

Section: Discussionsupporting

confidence: 80%

“…An extensive review published by Maloney et al [4] identified a total of 18 patients with SJS/TEN following treatment with different anti-PD-1 agents (pembrolizumab, ipilimumab, nivolumab, and atezolizumab) [4]. We conducted a comprehensive search to identify nivolumab-induced SJS and/or TEN cases (either as a mono- therapy or combination therapy), which yielded 11 patients [12][13][14][15][16][17][18][19][20][21][22]. One patient was managed with dual therapy with ipilimumab, and one was treated with nivolumab after the failure of ipilimumab.…”

Section: Discussionmentioning

confidence: 99%

“…No trials of nivolumab rechallenge after SJS/TEN diagnosis were attempted in the available literature [4]. Immunosuppressive therapy with systemic steroids was associated with better outcomes of SJS, as all the seven cases of nivolumab-induced SJS (without TEN) had survived [14,16,[18][19][20][21][22]. Furthermore, a recent meta-analysis has reported a beneficial role for cyclosporin (CsA) in SJS/TEN management, as CsA may block the cytotoxic T cells-induced epithelial cell injury [26].…”

Section: Discussionmentioning

confidence: 99%

“…SJS/TEN rash onset ranged from 1 week [ 16 , 20 ] to 4 months [ 14 ] with an average latency of 2 - 4 weeks. Interestingly, in the latter case [ 14 ], SJS rash appeared after eight cycles of nivolumab therapy in a similar pattern of delayed autoimmune diseases [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

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Steven-Johnson Syndrome: A Rare but Serious Adverse Event of Nivolumab Use in a Patient With Metastatic Gastric Adenocarcinoma

et al. 2022

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Nivolumab is a humanized monoclonal anti-programmed cell death receptor-1 (PD-1) antibody that has been authorized for use in the treatment of advanced malignancies. Cutaneous reactions are the most common immune-related adverse events reported with anti-PD-1 agents, and they range broadly from mild localized reactions to rarely severe or life-threatening systemic dermatoses. The occurrence of Steven-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) with nivolumab use is an exceedingly rare phenomenon that was only documented in a handful of cases in the current literature, but it deserves careful attention as SJS/TEN may be associated with fatal outcomes. We present a case of nivolumab-induced SJS/TEN in a middle-aged female patient with metastatic gastric adenocarcinoma that was successfully treated with immunosuppressive therapy and supportive care. Prompt recognition of SJS/TEN with discontinuation of nivolumab is warranted when SJS/TEN is suspected clinically. Multidisciplinary management in a specialized burn unit is the key to improving outcomes of SJS/TEN.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Steven-Johnson Syndrome: A Rare but Serious Adverse Event of Nivolumab Use in a Patient With Metastatic Gastric Adenocarcinoma

et al. 2022

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“…However, cases in which anti-PD-1/anti-PD-L1 drugs contribute to SJS are rare[ 3 ]. There have been several reports of anti-PD-1/anti-PD-L1 therapy inducing SJS[ 6 - 14 , 15 ]. Here, we present our report of a rare case of pembrolizumab-associated SJS in a female patient with advanced squamous cell carcinoma of the lung.…”

Section: Introductionmentioning

confidence: 99%

Pembrolizumab-induced Stevens-Johnson syndrome in advanced squamous cell carcinoma of the lung: A case report and review of literature

Wu¹,

Kang²,

Yi³

et al. 2022

WJCC

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BACKGROUND For advanced lung squamous cell carcinoma, immune checkpoint inhibitors (ICIs) have been regarded as one of the optimal therapies. While immune-related adverse events (irAEs) are common in ICI treatment, cutaneous toxicities are among the most common irAEs. Most immune-related skin toxicity grades are low, and the prognosis is good. However, Stevens-Johnson syndrome (SJS) is a rare but extremely severe cutaneous adverse drug reaction with high mortality. CASE SUMMARY We report a rare case of SJS induced by pembrolizumab. The case involved a 68-year-old female who was diagnosed with advanced squamous cell carcinoma of the lung. SJS appeared after one cycle of immunotherapy combined with chemotherapy. After treatment with prednisone hormone symptoms, anti-infection, gamma globulin, and antipruritic agents, the skin toxicity of the patients gradually decreased and eventually disappeared. Although the antitumor treatment was stopped due to serious adverse reactions, the tumor of the patient remained stable for nearly half a year after one cycle of immune therapy combined with chemotherapy, which also corroborates the delayed effect of immunotherapy. CONCLUSION We believe our report can provide some references for the treatment of SJS and the treatment of immune-related adverse reactions.

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Nivolumab

2021

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Nivolumab-associated Stevens-Johnson syndrome in a patient with lung cancer

Cited by 11 publications

References 9 publications

Steven-Johnson Syndrome: A Rare but Serious Adverse Event of Nivolumab Use in a Patient With Metastatic Gastric Adenocarcinoma

Steven-Johnson Syndrome: A Rare but Serious Adverse Event of Nivolumab Use in a Patient With Metastatic Gastric Adenocarcinoma

Pembrolizumab-induced Stevens-Johnson syndrome in advanced squamous cell carcinoma of the lung: A case report and review of literature

Nivolumab

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