The successful management of SJS/TEN secondary to enfortumab vedotin therapy
A 47-year-old female with poorly differentiated carcinoma of urothelial origin on pembrolizumab, presented to the hospital with fever, dysuria, pruritus, diffuse erythema, and skin desquamation 11 days after starting immunotherapy with enfortumab vedotin (EV). The desquamation covered about 25% of h...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-06-01
|
| Series: | Current Problems in Cancer: Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666621922000266 |
| _version_ | 1811226308856774656 |
|---|---|
| author | Rhea Singh, BS Fnu Nutan, MD |
| author_facet | Rhea Singh, BS Fnu Nutan, MD |
| author_sort | Rhea Singh, BS |
| collection | DOAJ |
| description | A 47-year-old female with poorly differentiated carcinoma of urothelial origin on pembrolizumab, presented to the hospital with fever, dysuria, pruritus, diffuse erythema, and skin desquamation 11 days after starting immunotherapy with enfortumab vedotin (EV). The desquamation covered about 25% of her body surface area and she subsequently developed a positive Nikolsky sign, bullae, and oral erosions. Labs were significant for elevated LFTs: 121 u/L (AST), 129 u/L (ALT), 147 u/L (ALP), CBC, and BMP were within normal limits.Histopathology demonstrated a vacuolar interface dermatitis consistent with an adverse drug reaction.EV was immediately stopped, and two doses of Etanercept 50 mg were administered subcutaneously followed by a three-day course of 200 mg IVIG, resulting in dramatic improvement of her rash. The patient required an ICU stay for worsening respiratory status and was discharged after five days of admission.According to a phase II trial, 48% of individuals receiving EV therapy developed treatment-related rashes. Post-marketing analysis data presented eight cases of serious skin reactions defined as either Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN) after EV therapy. The majority of reports are from singular cases or case series. Further research is necessary to establish the real-world incidence of SJS/TEN in post market analysis from EV and management of the same. |
| first_indexed | 2024-04-12T09:23:02Z |
| format | Article |
| id | doaj.art-bded6801272f4461a652b72128bfa766 |
| institution | Directory Open Access Journal |
| issn | 2666-6219 |
| language | English |
| last_indexed | 2024-04-12T09:23:02Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Current Problems in Cancer: Case Reports |
| spelling | doaj.art-bded6801272f4461a652b72128bfa7662022-12-22T03:38:34ZengElsevierCurrent Problems in Cancer: Case Reports2666-62192022-06-016100162The successful management of SJS/TEN secondary to enfortumab vedotin therapyRhea Singh, BS0Fnu Nutan, MD1Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Corresponding author at 1201 E Marshall St, Richmond, VA 23298.Department of Dermatology, Virginia Commonwealth University School of Medicine, Richmond, VA, USAA 47-year-old female with poorly differentiated carcinoma of urothelial origin on pembrolizumab, presented to the hospital with fever, dysuria, pruritus, diffuse erythema, and skin desquamation 11 days after starting immunotherapy with enfortumab vedotin (EV). The desquamation covered about 25% of her body surface area and she subsequently developed a positive Nikolsky sign, bullae, and oral erosions. Labs were significant for elevated LFTs: 121 u/L (AST), 129 u/L (ALT), 147 u/L (ALP), CBC, and BMP were within normal limits.Histopathology demonstrated a vacuolar interface dermatitis consistent with an adverse drug reaction.EV was immediately stopped, and two doses of Etanercept 50 mg were administered subcutaneously followed by a three-day course of 200 mg IVIG, resulting in dramatic improvement of her rash. The patient required an ICU stay for worsening respiratory status and was discharged after five days of admission.According to a phase II trial, 48% of individuals receiving EV therapy developed treatment-related rashes. Post-marketing analysis data presented eight cases of serious skin reactions defined as either Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN) after EV therapy. The majority of reports are from singular cases or case series. Further research is necessary to establish the real-world incidence of SJS/TEN in post market analysis from EV and management of the same.http://www.sciencedirect.com/science/article/pii/S2666621922000266SJSTENEnfortumab vedotinEtanercept |
| spellingShingle | Rhea Singh, BS Fnu Nutan, MD The successful management of SJS/TEN secondary to enfortumab vedotin therapy Current Problems in Cancer: Case Reports SJS TEN Enfortumab vedotin Etanercept |
| title | The successful management of SJS/TEN secondary to enfortumab vedotin therapy |
| title_full | The successful management of SJS/TEN secondary to enfortumab vedotin therapy |
| title_fullStr | The successful management of SJS/TEN secondary to enfortumab vedotin therapy |
| title_full_unstemmed | The successful management of SJS/TEN secondary to enfortumab vedotin therapy |
| title_short | The successful management of SJS/TEN secondary to enfortumab vedotin therapy |
| title_sort | successful management of sjs ten secondary to enfortumab vedotin therapy |
| topic | SJS TEN Enfortumab vedotin Etanercept |
| url | http://www.sciencedirect.com/science/article/pii/S2666621922000266 |
| work_keys_str_mv | AT rheasinghbs thesuccessfulmanagementofsjstensecondarytoenfortumabvedotintherapy AT fnunutanmd thesuccessfulmanagementofsjstensecondarytoenfortumabvedotintherapy AT rheasinghbs successfulmanagementofsjstensecondarytoenfortumabvedotintherapy AT fnunutanmd successfulmanagementofsjstensecondarytoenfortumabvedotintherapy |