Toxic epidermal necrolysis associated with nivolumab treatment for head and neck cancer

Koshizuka, Keiichi; Sakurai, Daiju; Sunagane, Miki; Mita, Yukiyoshi; Hamasaki, Sawako; Suzuki, Takeshi; Kikkawa, Naoko; Nakano, Miyo; Hanazawa, Toyoyuki

doi:10.1002/ccr3.3695

Cited by 8 publications

(6 citation statements)

References 11 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, compared to other medications such as lamotrigine when SJS manifested within the first few days of drug exposure [ 4 ], a relatively long latency of nivolumab-induced SJS (few weeks) is observed, and this finding may be explained by the different pharmacokinetics profile of nivolumab which reaches the steady-state concentration after 12 weeks with a half-life of 25 days [ 23 ]. The lack of prodromal symptoms in our patient is in line with the reviewed literature that reported constitutional symptoms in three cases only [ 16 , 17 , 19 ].…”

Section: Discussionsupporting

confidence: 91%

“…Table 3 outlines baseline patient characteristics, latency onset, the clinical presentation of SJS/TEN, and outcome and management for each patient. 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 ].…”

Section: Discussionsupporting

confidence: 86%

“…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 ]. TEN was associated with much worse mortality rates as all four patients with TEN died from polymicrobial sepsis and progression of the underlying malignancies [ 12 , 13 , 15 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2022

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In total, 95 cases of ICI‐induced SJS/TEN were identified from 55 peer‐reviewed publications, with 35 cases of SJS, two cases of SJS/TEN overlap, and 26 cases of TEN 7–63 (Figure 1a and Supporting Information Table S1). The precise nomination of the remaining 32 cases as SJS, SJS/TEN overlap or TEN was not specified by authors of the above publications.…”

Section: Resultsmentioning

confidence: 99%

Immune checkpoint inhibitor‐induced epidermal necrolysis: A narrative review evaluating demographics, clinical features, and culprit medications

Satoh,

Neulinger,

Stadler

et al. 2023

The Journal of Dermatology

View full text Add to dashboard Cite

Immune checkpoint inhibitors (ICIs) have transformed cancer treatment but can cause immune‐related adverse events (irAEs). Severe cutaneous irAEs, including epidermal necrolysis, are rare but potentially life‐threatening. There is limited understanding of the clinical features and management of ICI‐induced Stevens‐Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), so we aimed to analyze 95 cases of ICI‐induced SJS/TEN (35 cases of SJS, 26 cases of TEN, two cases of SJS/TEN overlap, and 32 cases of unspecified) to increase knowledge of this condition among oncologists and dermatologists. We conducted a comprehensive search of PubMed for all relevant case reports published until the end of December 2022, and collected data on patient demographics, cancer type, ICI regimen, time to onset of SJS/TEN, clinical presentation, management strategies, and outcomes. PD‐1 inhibitors were the most common ICIs associated with SJS/TEN (58.9%), followed by the combination of PD‐1 and CTLA‐4 inhibitors (11.6%), and PD‐L1 inhibitors (6.3%). Lung cancer and melanoma were the most frequent malignancies treated (35.8% and 25.4%, respectively). SJS/TEN occurred most frequently within the first 4 weeks (51.7%), and corticosteroid monotherapy was the most commonly chosen systemic treatment (56.4%). The overall mortality rate of ICI‐induced SJS/TEN was 30.8%. Our findings highlight the frequency and severity of ICI‐induced SJS/TEN and the urgent need for predictive molecular biomarkers aimed at preventive measures and early intervention.

show abstract

“…Сообщалось о различных неблагоприятных событиях, связанных с иммунитетом на фоне терапии ниволумабом, так как механизм действия препарата отличается от механизма действия обычных противоопухолевых препаратов [7,8].…”

Section: Introductionunclassified

Anti-PD‑1-induced type 1 diabetes mellitus in patient with recurrent oropharyngeal squamous cell cancer

Lyanova¹,

Vladimirova²,

Абрамова³

et al. 2023

Medicinskij alfavit

View full text Add to dashboard Cite

Ростов-на-Дону 2 Больница Christiana Care, г. Ньюарк, штат Делавэр, США РЕЗЮМЕ Ингибиторы иммунных контрольных точек, нацеленные на запрограммированный лиганд гибели клеток PD-L1, стали крупным прорывом в лечении многих онкологических заболеваний. Ниволумаб -это антитело, избирательно блокирующее рецептор PD-1 на поверхности цитотоксических Т-клеток для предотвращения подавления регуляции иммунного ответа. Известно, что ингибиторы иммунных контрольных точек могут вызывать так называемые иммуноопосредованные нежелательные явления, в том числе со стороны эндокринной системы. Сахарный диабет 1 типа является одним из тяжелых редких и потенциально опасных для жизни иммуноопосредованных нежелательных явлений, встречающихся менее чем у 1 % пациентов, получающих лечение ингибиторами иммунных контрольных точек. Хотя общая частота сахарного диабета 1 типа, связанного с ингибитором PD-1, относительно низка, тем не менее он имеет молниеносное течение и может представлять потенциальную угрозу для жизни пациентов, если не будут проведены своевременная диагностика и лечение. Поскольку ингибиторы PD-1 широко используются для лечения многих злокачественных заболеваний, осложнения в виде диабета 1 типа должны привлекать внимание врачей. Кроме того, нельзя не учитывать тот факт, что в ходе лечения врачи должны помогать пациентам лучше распознавать симптомы гипергликемии или диабетического кетоацидоза, что требует тщательного наблюдения за ними во время лечения, регулярного мониторинга уровня глюкозы в плазме крови, оперативного выявления и правильной диагностики и лечения диабета.

show abstract

Toxic epidermal necrolysis associated with nivolumab treatment for head and neck cancer

Abstract: This report is the first to document TEN caused by nivolumab treatment in head and neck cancer. We believe this article can contribute significantly in understanding the principles of nivolumab treatment in patients with head and neck cancer.

Cited by 8 publications

References 11 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

Immune checkpoint inhibitor‐induced epidermal necrolysis: A narrative review evaluating demographics, clinical features, and culprit medications

Anti-PD‑1-induced type 1 diabetes mellitus in patient with recurrent oropharyngeal squamous cell cancer

Contact Info

Product

Resources

About