☆ 4.5 Review

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

JOURNAL OF DERMATOLOGY (2023)

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Immune-checkpoint inhibitors: long-term implications of toxicity

Douglas B. Johnson et al.

Summary: Immune-checkpoint inhibitors have improved outcomes for advanced-stage solid tumour patients, but they also carry the risk of chronic toxicities that can affect patients' quality of life. While evidence on chronic toxicities is limited, emerging evidence suggests that they may be more common than previously thought. These toxicities can affect various organ systems and may even lead to fatal outcomes. Research on the effects of immune-checkpoint blockade on other immune processes is also important for cancer survivors.

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Article Oncology

Cutaneous Stevens Johnson - Toxic Epidermal Necrolysis Immunotherapy related Toxicities in Lung Cancer Patients

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Summary: This article presents two severe skin toxicity cases of lung cancer patients undergoing PD-1/PD-L1 immunotherapy. The authors briefly review the mechanisms of major toxicities caused by PD-1/PD-L1 blockade and emphasize the importance of promptly identifying these adverse events for effective management and safe treatment.

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Article Ophthalmology

Pembrolizumab-induced Stevens-Johnson Syndrome with Severe Ocular Complications

Soyoung Ryu et al.

Summary: This case report highlights a unique case of Stevens-Johnson syndrome with severe ocular complications induced by pembrolizumab, an immune checkpoint inhibitor. The patient's symptoms improved after cessation of pembrolizumab treatment and administration of steroids systemically. Immune checkpoint inhibitors have been widely used in cancer treatment, but may lead to adverse events, such as SJS with severe ocular complications.

OCULAR IMMUNOLOGY AND INFLAMMATION (2022)

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Article Oncology

Intravenous immunoglobulin efficacy on pembrolizumab induced severe toxic epidermal necrolysis

Waleed Kian et al.

Summary: This article reports a case of toxic epidermal necrolysis in a patient with non-small cell lung cancer following the use of pembrolizumab, which was completely resolved through the use of intravenous immunoglobulin.

ANTI-CANCER DRUGS (2022)

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Article Dermatology

Pembrolizumab associated Stevens-Johnson syndrome with porokeratosis in a patient in the setting of primary hepatocellular carcinoma

Jing Zhang et al.

Summary: This study reports an extremely rare case of a 32-year-old man who developed Stevens-Johnson syndrome and porokeratosis simultaneously during pembrolizumab treatment for primary hepatocellular carcinoma.

AUSTRALASIAN JOURNAL OF DERMATOLOGY (2022)

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Review Biotechnology & Applied Microbiology

Immune-related toxicities of checkpoint inhibitors: mechanisms and mitigation strategies

Ryan J. Sullivan et al.

Summary: The Review by Weber and Sullivan highlights the different types of immune-related adverse events associated with checkpoint inhibitors and discusses how their treatment and identification of possible predictive biomarkers may shed light on their mechanisms, as well as possible strategies and targets for prophylactic and therapeutic interventions to mitigate them.

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Article Oncology

Severe blistering eruptions induced by immune checkpoint inhibitors: a multicentre international study of 32 cases

Saskia Ingen-Housz-Oro et al.

Summary: This study retrospectively examined the clinical features, diagnosis, and treatment of severe blistering cutaneous reactions induced by immune checkpoint inhibitors (ICI). The results showed that these reactions are often misdiagnosed as epidermal necrolysis but are more likely to be severe lichenoid dermatosis. Most patients received topical treatment during the acute phase and discontinued the culprit ICI. A small number of patients tolerated another ICI well.

MELANOMA RESEARCH (2022)

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Review Biotechnology & Applied Microbiology

Treatment of PD-1 Inhibitor-Associated Toxic Epidermal Necrolysis: A Case Report and Brief Review

Yidong Zhao et al.

Summary: This case report presents a rare occurrence of toxic epidermal necrolysis in a patient with gallbladder carcinoma treated with Sintilimab. The patient's skin lesions were effectively treated and improved.

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Cutaneous immune-related adverse events among Taiwanese cancer patients receiving immune checkpoint inhibitors link to a survival benefit

Yung-Tsu Cho et al.

Summary: A study conducted in Taiwan found that cutaneous immune-related adverse events are common in cancer patients receiving immunotherapies, with skin rash and pruritus being most frequently identified. Patients receiving different drugs may have varying incidence rates, and concurrent usage of molecular targeted therapy is associated with higher rates.

SCIENTIFIC REPORTS (2022)

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Article Medicine, General & Internal

Pembrolizumab-induced toxic epidermal necrolysis: case report

Kar Ven Cavan Chow et al.

Summary: This case report describes a 63-year-old man with metastatic lung adenocarcinoma who developed toxic epidermal necrolysis (TEN) following treatment with pembrolizumab. The patient was managed with immunosuppressive therapy and achieved excellent recovery. This rare occurrence highlights the importance of recognizing and managing this complication, especially considering the increasing use of immune checkpoint inhibitors.

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Letter Dermatology

A case of sintilimab-induced SJS/TEN:Dermatologic adverse reactions associated with programmed cell death protein-1 inhibitors

Ying Huang et al.

DERMATOLOGIC THERAPY (2022)

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Article Pharmacology & Pharmacy

A case report involving suppressed nuclear receptor transcription factors 4a1 and Stevens-Johnson syndrome induced by a single dose of pembrolizumab and successfully treated with early steroid administration, resulting in complete remission of stage III lung cancer

Maiko Machida et al.

Summary: This case study indicates the potential clinical benefit of evaluating Nr4a expression-related indices as possible clinical covariates and may act as a milestone for appropriate future chemotherapy interventions.

JOURNAL OF PHARMACEUTICAL HEALTH CARE AND SCIENCES (2022)

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Review Medicine, General & Internal

Pembrolizumab-induced Stevens-Johnson syndrome in advanced squamous cell carcinoma of the lung: A case report and review of literature

Jing-Yi Wu et al.

Summary: This report describes a rare case of Stevens-Johnson syndrome (SJS) induced by pembrolizumab in a patient with advanced lung squamous cell carcinoma. Despite the serious adverse reactions and the discontinuation of tumor treatment, the patient's tumor remained stable for nearly half a year, providing evidence for the delayed effect of immunotherapy.

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Letter Oncology

Toxic epidermal necrolysis after immune checkpoint inhibition, case report, and review of the literature

Hanne Sommerfelt et al.

ACTA ONCOLOGICA (2022)

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Article Immunology

Toxic epidermal necrolysis induced by sintilimab in a patient with advanced non-small cell lung cancer and comorbid pulmonary tuberculosis: A case report

Gang Li et al.

Summary: This report discusses a case of a patient with advanced non-small cell lung cancer (NSCLC) and comorbid pulmonary tuberculosis who developed toxic epidermal necrolysis (TEN) after receiving immunotherapy and chemotherapy. The importance of monitoring rare but severe cutaneous toxicities in patients treated with Sintilimab is emphasized.

FRONTIERS IN IMMUNOLOGY (2022)

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Article Dermatology

Bullous drug reaction after pembrolizumab administration: two case reports

L. Golle et al.

Summary: Severe adverse drug reactions involving the skin, such as Stevens-Johnson syndrome and toxic epidermal necrolysis, can be triggered by allopurinol, anticonvulsants, sulphonamide antibiotics, non-steroidal anti-inflammatory drugs, and immunotherapies. This study presents two cases of bullous skin symptoms after administration of the checkpoint inhibitor pembrolizumab. Histological assessment is often necessary due to the difficulty of unequivocal classification based on clinical symptoms.

DERMATOLOGIE (2022)

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Letter Dermatology

Immunohistochemical Expression of PD-L1 Is Increased in Lesional Epidermal Keratinocytes in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

Carolyn M. Ziemer et al.

AMERICAN JOURNAL OF DERMATOPATHOLOGY (2021)

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Article Dermatology

Cutaneous adverse events caused by immune checkpoint inhibitors

Henry T. Quach et al.

Summary: ICIs can lead to a variety of cutaneous adverse events, ranging from common eczematous and morbilliform dermatoses to less common psoriasiform dermatoses and bullous disorders. The immunologic mechanism of ICIs may also cause rheumatologic adverse reactions with cutaneous manifestations, which can typically be managed with steroids. As ICIs become more widely prescribed, dermatologists will play a crucial role in accurately diagnosing and treating these toxicities to ensure favorable outcomes for patients.

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY (2021)

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Letter Oncology

Immune checkpoint inhibitor-related epidermal necrolysis: A rare condition with poor prognosis

Chunxia He et al.

EUROPEAN JOURNAL OF CANCER (2021)

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Article Ophthalmology

Ocular manifestations of anti-neoplastic immune checkpoint inhibitor-associated Stevens-Johnson syndrome/toxic epidermal necrolysis in cancer patients

Kevin Sheng-Kai Ma et al.

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Case Report: Stevens-Johnson Syndrome and Hepatotoxicity Induced by Osimertinib Sequential to Pembrolizumab in a Patient With EGFR-Mutated Lung Adenocarcinoma

Caterina Gianni et al.

Summary: Lung cancer is a complex disease with treatment options depending on histological characteristics and genetic mutations, with the use of TKIs and ICIs at different stages potentially leading to more severe adverse events. In cases of EGFR-mutated lung adenocarcinoma, using TKIs as the frontline treatment may be a more rational and safer option.

FRONTIERS IN PHARMACOLOGY (2021)

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Article Oncology

Pembrolizumab-induced autoimmune Stevens-Johnson syndrome/toxic epidermal necrolysis with myositis and myocarditis in a patient with esophagogastric junction carcinoma: a case report

Jiashun Cao et al.

Summary: Immune checkpoint inhibitors (ICIs) have improved outcomes for cancer patients, but their adverse reactions, such as severe skin rash and myocarditis, require early recognition and high-dose corticosteroids for successful treatment. Fatal adverse events associated with ICIs can progress rapidly and involve multiple systems and organs, necessitating a deep understanding and vigilance from healthcare providers.

TRANSLATIONAL CANCER RESEARCH (2021)

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Article Oncology

T cell mediated hypersensitivity to previously tolerated iodinated contrast media precipitated by introduction of atezolizumab

Sean Hammond et al.

Summary: This study presented a case of a patient who developed immune-related adverse reactions after receiving ICI treatment, with experimental confirmation of the potential interactions between ICIs and other medications. It underscores the importance of considering all concomitant medications in patients receiving ICIs.

JOURNAL FOR IMMUNOTHERAPY OF CANCER (2021)

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Review Medicine, General & Internal

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management

Robert Frantz et al.

Summary: Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis are rare diseases with significant morbidity and mortality. Recent research has identified potential biomarkers and treatment options, but more prospective, randomized controlled trials are needed for valuable insights into disease management.

MEDICINA-LITHUANIA (2021)

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Article Medicine, General & Internal

A Case of Guillain-Barre Syndrome and Stevens-Johnson Syndrome/Toxic Epidermal Necrosis Overlap After Pembrolizumab Treatment

Tomoyo Oguri et al.

Summary: A 76-year-old man developed Guillain-Barre syndrome and Stevens-Johnson syndrome/toxic epidermal necrosis overlap as immune-related adverse events following pembrolizumab treatment for lung adenocarcinoma. Despite improvement in skin symptoms, he ultimately died of aspiration pneumonia related to GBS. It is important to be cautious of the potential occurrence of severe immune-related adverse events simultaneously.

JOURNAL OF INVESTIGATIVE MEDICINE HIGH IMPACT CASE REPORTS (2021)

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Letter Dermatology

Recurrence of nivolumab-induced Stevens-Johnson syndrome due to tegafur/gimeracil/oteracil (TS-1®) after nivolumab discontinuation

Takayoshi Komatsu-Fujii et al.

EUROPEAN JOURNAL OF DERMATOLOGY (2021)

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Article Medicine, General & Internal

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

Keiichi Koshizuka et al.

Summary: This report is the first to document cases of TEN caused by nivolumab treatment in head and neck cancer patients. It is believed that this article can significantly contribute to understanding the principles of nivolumab treatment in this patient population.

CLINICAL CASE REPORTS (2021)

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Editorial Material Oncology

Pembrolizumab induced toxic epidermal necrolysis

Rohit Kumar et al.

CURRENT PROBLEMS IN CANCER (2020)

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Article Dermatology

Pembrolizumab-Induced Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis in a Patient With Metastatic Cervical Squamous Cell Carcinoma: A Case Report

Shamika Robinson et al.

AMERICAN JOURNAL OF DERMATOPATHOLOGY (2020)

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Review Oncology

Combination Therapy of Ipilimumab and Nivolumab-associated Toxic Epidermal Necrolysis (TEN) in a Patient With Metastatic Melanoma: A Case Report and Literature Review

Ian T. Logan et al.

JOURNAL OF IMMUNOTHERAPY (2020)

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Review Dermatology

Stevens-Johnson syndrome and toxic epidermal necrolysis-like reactions to checkpoint inhibitors: a systematic review

Nolan J. Maloney et al.

INTERNATIONAL JOURNAL OF DERMATOLOGY (2020)

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Letter Dermatology

Nivolumab-induced toxic epidermal necrolysis with retiform purpura

P. Basu et al.

BRITISH JOURNAL OF DERMATOLOGY (2020)

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Letter Oncology

Toxic epidermal necrolysis accompanied by several immune-related adverse events developed after discontinuation of nivolumab

Yuko Watanabe et al.

EUROPEAN JOURNAL OF CANCER (2020)

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Article Oncology

Toxic epidermal necrolysis associated with pembrolizumab

Zhuo Ran Cai et al.

JOURNAL OF ONCOLOGY PHARMACY PRACTICE (2020)

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Letter Dermatology

Generalized bullous mucocutaneous eruption mimicking Stevens-Johnson syndrome in the setting of immune checkpoint inhibition: A multicenter case series

Gabriel E. Molina et al.

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY (2020)

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Cutaneous adverse reactions to anti-PD-1 treatment-A systematic review

Anne Birgitte Simonsen et al.

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY (2020)

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Absence of toxic epidermal necrolysis recurrence with pembrolizumab re-challenge in a patient with a positive lymphocyte transformation test

Moeka Kawada et al.

JOURNAL OF DERMATOLOGY (2020)

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Letter Oncology

Esomeprazole-induced Stevens-Johnson syndrome in a patient who underwent nivolumab therapy for advanced lung adenocarcinoma

Yi-Tsz Lin et al.

LUNG CANCER (2020)

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Review Dermatology

Stevens-Johnson syndrome and toxic epidermal necrolysis related to immune checkpoint inhibitors: Two cases and literature review

Ting-Jung Hsu et al.

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Atypical Stevens-Johnson Syndrome Caused by Pembrolizumab in the Treatment of Metastatic Melanoma - Are Corticosteroids a Safe Treatment Option?

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Late-onset Stevens-Johnson syndrome due to nivolumab use for hepatocellular carcinoma

Constantin A. Dasanu

JOURNAL OF ONCOLOGY PHARMACY PRACTICE (2019)

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

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Acute toxic epidermal necrolysis reaction post single dose pembrolizumab with preceding cephalosporin exposure: successful rechallenge with anti-PD-1 therapy

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Article Dermatology

Atezolizumab-Induced Stevens-Johnson Syndrome in a Patient with Non-Small Cell Lung Carcinoma

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Toxic epidermal necrolysis due to anti-PD1 treatment with fatal outcome

S. Demirtas et al.

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UK guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults 2016

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Jedd D. Wolchok et al.

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Meeting Abstract Oncology

Safety and Efficacy of First-Line Nivolumab (Anti-PD-1; BMS-936558, ONO-4538) and Ipilimumab in Non-Small Cell Lung Cancer (NSCLC)

S. J. Antonia et al.

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