Pembrolizumab-Induced Toxic Epidermal Necrolysis
Immunotherapy has nowadays become part of the mainstay of treatment for several cancers. In this report, we present a case of toxic epidermal necrolysis (TEN) occurring as a relatively rare complication of pembrolizumab, which is a humanized monoclonal anti-programmed cell death-1 (anti-PD1) IgG4 an...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2022-10-01
|
| Series: | Case Reports in Oncology |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/526931 |
| _version_ | 1797990318373601280 |
|---|---|
| author | Luca Borg Malcolm Buhagiar Elisa La Ferla David Pisani Janabel Said Michael J. Boffa |
| author_facet | Luca Borg Malcolm Buhagiar Elisa La Ferla David Pisani Janabel Said Michael J. Boffa |
| author_sort | Luca Borg |
| collection | DOAJ |
| description | Immunotherapy has nowadays become part of the mainstay of treatment for several cancers. In this report, we present a case of toxic epidermal necrolysis (TEN) occurring as a relatively rare complication of pembrolizumab, which is a humanized monoclonal anti-programmed cell death-1 (anti-PD1) IgG4 antibody that targets tumours expressing PDL-1. In our case, this monoclonal antibody (MAB) was being used for the treatment of metastatic non-small cell lung cancer, before being withheld because of this potentially life-threatening reaction. There are no guidelines on the optimal management of TEN, with varying reports on the efficacy on steroids, intravenous immunoglobulin (IVIG), and cyclosporin. In this report, we describe a case of TEN following the second dose of three-weekly pembrolizumab in a 50-year-old man, comparing it to four similar cases reported in the literature. It is important that oncologists are aware of this potentially life-threatening adverse reaction of pembrolizumab, as early recognition and treatment of TEN are essential to improve clinical outcome. |
| first_indexed | 2024-04-11T08:34:45Z |
| format | Article |
| id | doaj.art-ba1ab76fb7284bd6b5e2060636ead827 |
| institution | Directory Open Access Journal |
| issn | 1662-6575 |
| language | English |
| last_indexed | 2024-04-11T08:34:45Z |
| publishDate | 2022-10-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Oncology |
| spelling | doaj.art-ba1ab76fb7284bd6b5e2060636ead8272022-12-22T04:34:22ZengKarger PublishersCase Reports in Oncology1662-65752022-10-0115388789310.1159/000526931526931Pembrolizumab-Induced Toxic Epidermal NecrolysisLuca Borg0Malcolm Buhagiar1Elisa La Ferla2David Pisani3https://orcid.org/0000-0002-5017-7619Janabel Said4Michael J. Boffa5Department of Medicine, Mater Dei Hospital, Msida, MaltaDepartment of Oncology, Sir Anthony Mamo Oncology Centre, Msida, MaltaDepartment of Medicine, Mater Dei Hospital, Msida, MaltaDepartment of Pathology, Mater Dei Hospital, Msida, MaltaDepartment of Oncology, Sir Anthony Mamo Oncology Centre, Msida, MaltaDepartment of Dermatology, Mater Dei Hospital, Msida, MaltaImmunotherapy has nowadays become part of the mainstay of treatment for several cancers. In this report, we present a case of toxic epidermal necrolysis (TEN) occurring as a relatively rare complication of pembrolizumab, which is a humanized monoclonal anti-programmed cell death-1 (anti-PD1) IgG4 antibody that targets tumours expressing PDL-1. In our case, this monoclonal antibody (MAB) was being used for the treatment of metastatic non-small cell lung cancer, before being withheld because of this potentially life-threatening reaction. There are no guidelines on the optimal management of TEN, with varying reports on the efficacy on steroids, intravenous immunoglobulin (IVIG), and cyclosporin. In this report, we describe a case of TEN following the second dose of three-weekly pembrolizumab in a 50-year-old man, comparing it to four similar cases reported in the literature. It is important that oncologists are aware of this potentially life-threatening adverse reaction of pembrolizumab, as early recognition and treatment of TEN are essential to improve clinical outcome.https://www.karger.com/Article/FullText/526931pembrolizumabtoxic epidermal necrolysissteroidsintravenous immuoglobulincyclosporinnon-small cell lung cancerimmunotherapy |
| spellingShingle | Luca Borg Malcolm Buhagiar Elisa La Ferla David Pisani Janabel Said Michael J. Boffa Pembrolizumab-Induced Toxic Epidermal Necrolysis Case Reports in Oncology pembrolizumab toxic epidermal necrolysis steroids intravenous immuoglobulin cyclosporin non-small cell lung cancer immunotherapy |
| title | Pembrolizumab-Induced Toxic Epidermal Necrolysis |
| title_full | Pembrolizumab-Induced Toxic Epidermal Necrolysis |
| title_fullStr | Pembrolizumab-Induced Toxic Epidermal Necrolysis |
| title_full_unstemmed | Pembrolizumab-Induced Toxic Epidermal Necrolysis |
| title_short | Pembrolizumab-Induced Toxic Epidermal Necrolysis |
| title_sort | pembrolizumab induced toxic epidermal necrolysis |
| topic | pembrolizumab toxic epidermal necrolysis steroids intravenous immuoglobulin cyclosporin non-small cell lung cancer immunotherapy |
| url | https://www.karger.com/Article/FullText/526931 |
| work_keys_str_mv | AT lucaborg pembrolizumabinducedtoxicepidermalnecrolysis AT malcolmbuhagiar pembrolizumabinducedtoxicepidermalnecrolysis AT elisalaferla pembrolizumabinducedtoxicepidermalnecrolysis AT davidpisani pembrolizumabinducedtoxicepidermalnecrolysis AT janabelsaid pembrolizumabinducedtoxicepidermalnecrolysis AT michaeljboffa pembrolizumabinducedtoxicepidermalnecrolysis |