Case report: Apalutamide-induced severe lethal cutaneous adverse effects in China
IntroductionApalutamide is a novel agent for castration-resistant prostate cancer while skin rashes are the most common untoward reactions. Up to now, most of the reported dermatologic adverse events (dAEs) allocated to mild and moderate with a fair prognosis. Herein, we report a case series of seve...
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1291564/full |
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| author | Qi Wang Qi Wang Huali Cao Xuetong Zhang Huifeng Wu Zhuangli Tang |
| author_facet | Qi Wang Qi Wang Huali Cao Xuetong Zhang Huifeng Wu Zhuangli Tang |
| author_sort | Qi Wang |
| collection | DOAJ |
| description | IntroductionApalutamide is a novel agent for castration-resistant prostate cancer while skin rashes are the most common untoward reactions. Up to now, most of the reported dermatologic adverse events (dAEs) allocated to mild and moderate with a fair prognosis. Herein, we report a case series of severe dAEs in China caused by apalutamide.Case presentationThe four patients all developed severe and lethal drug eruptions including Stevens-Johnson syndrome and toxic epidermal necrolysis with a mean incubation period of 40 days. On the basis of the medical condition, all the patients were suggested to withdraw apalutamide and three of them recovered. Of note, attempts of rechallenges of apalutamide may be fatal.DiscussionThe incidence of dAEs in previously conducted clinical trials exceeded 20%, with maculopapular rashes being the most common feature. However, the incidence and severity varied in different geographic regions and ethnicities. Inadequate attention was paid to severe cutaneous adverse reactions. Long latency may easily lead to the misdiagnosis of dAEs, and immediate withdrawal of apalutamide is the cornerstone of therapies.ConclusionSpecial and adequate attention should be paid to apalutamide-attributed severe cutaneous adverse effects. Besides, the prognosis of severe drug eruptions may be disappointing, and in-time withdrawal is vital. |
| first_indexed | 2024-03-08T14:48:38Z |
| format | Article |
| id | doaj.art-0b2d3c5b672e4eea970fae0cf55524c4 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-03-08T14:48:38Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj.art-0b2d3c5b672e4eea970fae0cf55524c42024-01-11T04:43:45ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-01-011410.3389/fimmu.2023.12915641291564Case report: Apalutamide-induced severe lethal cutaneous adverse effects in ChinaQi Wang0Qi Wang1Huali Cao2Xuetong Zhang3Huifeng Wu4Zhuangli Tang5Department of Dermatology, Second Affiliated Hospital of Zhejiang University, Hangzhou, ChinaDepartment of Dermatology, Changxing People’s Hospital, Huzhou, ChinaDepartment of Dermatology, Second Affiliated Hospital of Zhejiang University, Hangzhou, ChinaDepartment of Dermatology, Second Affiliated Hospital of Zhejiang University, Hangzhou, ChinaDepartment of Urology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Dermatology, Second Affiliated Hospital of Zhejiang University, Hangzhou, ChinaIntroductionApalutamide is a novel agent for castration-resistant prostate cancer while skin rashes are the most common untoward reactions. Up to now, most of the reported dermatologic adverse events (dAEs) allocated to mild and moderate with a fair prognosis. Herein, we report a case series of severe dAEs in China caused by apalutamide.Case presentationThe four patients all developed severe and lethal drug eruptions including Stevens-Johnson syndrome and toxic epidermal necrolysis with a mean incubation period of 40 days. On the basis of the medical condition, all the patients were suggested to withdraw apalutamide and three of them recovered. Of note, attempts of rechallenges of apalutamide may be fatal.DiscussionThe incidence of dAEs in previously conducted clinical trials exceeded 20%, with maculopapular rashes being the most common feature. However, the incidence and severity varied in different geographic regions and ethnicities. Inadequate attention was paid to severe cutaneous adverse reactions. Long latency may easily lead to the misdiagnosis of dAEs, and immediate withdrawal of apalutamide is the cornerstone of therapies.ConclusionSpecial and adequate attention should be paid to apalutamide-attributed severe cutaneous adverse effects. Besides, the prognosis of severe drug eruptions may be disappointing, and in-time withdrawal is vital.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1291564/fullapalutamidesevere dermatologic adverse eventslong incubation periodprognosiswithdrawal |
| spellingShingle | Qi Wang Qi Wang Huali Cao Xuetong Zhang Huifeng Wu Zhuangli Tang Case report: Apalutamide-induced severe lethal cutaneous adverse effects in China Frontiers in Immunology apalutamide severe dermatologic adverse events long incubation period prognosis withdrawal |
| title | Case report: Apalutamide-induced severe lethal cutaneous adverse effects in China |
| title_full | Case report: Apalutamide-induced severe lethal cutaneous adverse effects in China |
| title_fullStr | Case report: Apalutamide-induced severe lethal cutaneous adverse effects in China |
| title_full_unstemmed | Case report: Apalutamide-induced severe lethal cutaneous adverse effects in China |
| title_short | Case report: Apalutamide-induced severe lethal cutaneous adverse effects in China |
| title_sort | case report apalutamide induced severe lethal cutaneous adverse effects in china |
| topic | apalutamide severe dermatologic adverse events long incubation period prognosis withdrawal |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1291564/full |
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