Stevens-Johnson Syndrome Induced by Pembrolizumab in a Lung Cancer Patient

Haratake, Naoki; Tagawa, Tetsuzo; Hirai, Fumihiko; Toyokawa, Gouji; Miyazaki, Reiko; Maehara, Yoshihiko

doi:10.1016/j.jtho.2018.05.031

Cited by 26 publications

(17 citation statements)

References 3 publications

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“…Whenever severe erosive or bullous drug eruptions occur on checkpoint inhibitor therapy, it is essential to diagnose such reactions correctly. Table 1 provides a summary of and commentary to all cases of SJS/TEN and TEN-like reactions on checkpoint inhibitor therapy (CTLA4, PD-1 and PD-L1) (n = 14) published in German, English, and French and listed on PubMed [9][10][11][12][13][14][15][16][17][18][19][20][21]. According to our case analysis, it does seem much more likely that many of the published cases actually represented bullous lichenoid drug eruptions (some of which were associated with lichenoid mucosal involvement) or cases of isolated erosive lichenoid mucositis, as well as cases of epidermolytic reactions in areas previously irradiated (radiation recall).…”

Section: Clinical Lettermentioning

confidence: 99%

Severe bullous skin eruptions on checkpoint inhibitor therapy – in most cases severe bullous lichenoid drug eruptions

Reschke

Mockenhaupt

Simon

et al. 2019

J Deutsche Derma Gesell

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Section: Clinical Lettermentioning

confidence: 99%

Severe bullous skin eruptions on checkpoint inhibitor therapy – in most cases severe bullous lichenoid drug eruptions

Reschke

Mockenhaupt

Simon

et al. 2019

J Deutsche Derma Gesell

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“…Moreover, skin rashes greater than grade 3 are rare, especially in lung cancer 2 . But, patients developing SJS/TEN related to anti‐PD‐1 therapy, including pembrolizumab, have recently been reported 1,2 . Carboplatin and pemetrexed were added to the anti‐PD‐1 treatment regimen for lung cancer in the current patient.…”

Section: Figurementioning

confidence: 94%

“…Pembrolizumab is an anti‐programmed death‐1 (PD‐1) checkpoint inhibitor. Pembrolizumab has been associated with numerous cutaneous adverse side effects, including Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), which are rare but potentially fatal 1,2 …”

Section: Figurementioning

confidence: 99%

“…Cutaneous adverse events while on anti‐PD‐1 therapy are common 2 . Moreover, skin rashes greater than grade 3 are rare, especially in lung cancer 2 .…”

Section: Figurementioning

confidence: 99%

“…Cutaneous adverse events while on anti‐PD‐1 therapy are common 2 . Moreover, skin rashes greater than grade 3 are rare, especially in lung cancer 2 . But, patients developing SJS/TEN related to anti‐PD‐1 therapy, including pembrolizumab, have recently been reported 1,2 .…”

Section: Figurementioning

confidence: 99%

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Toxic epidermal necrolysis as a complication of pembrolizumab treatment in a lung cancer patient

Aoyama

Kondo

Azuma

et al. 2020

J Cutaneous Imm & Allergy

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Cutaneous adverse events are common, but most of them are not severe. We herein report a case of toxic epidermal necrolysis as a complication of pembrolizumab treatment in a lung cancer patient. Recent reports showed that anti‐PD1 therapy could increase the risk of a drug eruption alone or in combination with other drugs. Cutaneous adverse events while on anti‐PD‐1 therapy should be closely observed.

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Management of Cutaneous Immune-Related Adverse Events in Patients With Cancer Treated With Immune Checkpoint Inhibitors

2022

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IMPORTANCEThere exists a paucity of literature that summarizes the effective management of cutaneous immune-related adverse events (cirAEs) in patients with cancer who are receiving immune checkpoint inhibitors (ICIs). Most published articles are small case series from a single institution. To our knowledge, the spectrum of possible treatments has not been systematically reviewed to highlight the breadth of options when caring for patients with cirAEs.OBJECTIVE To further characterize the development of subtypes of cirAEs in patients with cancer treated with ICIs and provide recommendations on optimal treatment regimens based on the current literature.EVIDENCE REVIEW A search was performed in PubMed, Embase European, Web of Science, and Google Scholar on June 26, 2020, according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines, limited to the years 2010 to 2020. Articles that met predetermined inclusion criteria (published between January 1, 2010, and June 1, 2020; written in the English language; and original articles, brief reports, case reports, and research letters that reported primarily on cirAE management) were selected, and data were abstracted. Articles that met the scope of the review were also added from reference lists. When possible, the results of studies that addressed a similar question were combined quantitatively. FINDINGS In total, 138 studies (87 from the aforementioned literature search and 51 additional studies pulled from the reference lists of included articles) were included that reported on 879 cirAEs. The subtypes of cirAEs included maculopapular, pruritus, lichenoid, immunobullous, psoriasiform, granulomatous, erythema multiforme or Stevens Johnson Syndrome, drug rash with eosinophilia and systemic symptoms, connective tissue disease, hair, oral, and miscellaneous. Treatments for cirAEs included a combination of topical corticosteroids, systemic corticosteroids, steroid-sparing agents, and discontinuation or cessation of immunotherapy.CONCLUSIONS AND RELEVANCE This systematic review found that treatment with ICIs was associated with many types of skin toxic effects, each with unique treatment options beyond current published guidelines. Further research into key differences between subtypes is critical to improve the care provided to patients with cancer.

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Stevens-Johnson Syndrome Induced by Pembrolizumab in a Lung Cancer Patient

Cited by 26 publications

References 3 publications

Severe bullous skin eruptions on checkpoint inhibitor therapy – in most cases severe bullous lichenoid drug eruptions

Severe bullous skin eruptions on checkpoint inhibitor therapy – in most cases severe bullous lichenoid drug eruptions

Toxic epidermal necrolysis as a complication of pembrolizumab treatment in a lung cancer patient

Management of Cutaneous Immune-Related Adverse Events in Patients With Cancer Treated With Immune Checkpoint Inhibitors

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