Li Xi, Lei Yi, Liu Jiyan, Lin Hongyin, Chen Kexin, Yin Fang, Wang Chunhui, Zhang Hu
General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Discov Oncol. 2023 Aug 8;14(1):146. doi: 10.1007/s12672-023-00749-5.
Dermatological toxicities are well-recognized immune-related adverse events (irAEs) secondary to immune checkpoint inhibitor (ICI) use. Corticosteroids are considered the first-line therapy for grade 3 or grade 4 skin irAEs, but long-term usage of corticosteroids may abolish the effect of ICIs. Multiple antitumor therapies might be an influencing factor in an increased incidence of skin irAEs. The safety and prognostic value in resuming ICIs after irAEs has been inconsistently reported, especially the severe skin irAE. We report a case of a 75-year-old man with non-small cell lung cancer (NSCLC) and prostate cancer with a Stevens-Johnson syndrome (SJS)-like eruption. The severe rash might have been induced by resuming pembrolizumab was successfully treated with a combination of corticosteroids, gamma globulin, and immunosuppressants. Early detection of dermatologic toxicity is crucial, especially for patients receiving multiple antitumor treatments. We should treat ICI resumption seriously after skin irAE.
皮肤毒性是免疫检查点抑制剂（ICI）使用继发的公认的免疫相关不良事件（irAE）。皮质类固醇被认为是3级或4级皮肤irAE的一线治疗方法，但长期使用皮质类固醇可能会消除ICI的效果。多种抗肿瘤治疗可能是皮肤irAE发生率增加的一个影响因素。关于irAE后恢复使用ICI的安全性和预后价值的报道并不一致，尤其是严重的皮肤irAE。我们报告了一例75岁男性非小细胞肺癌（NSCLC）和前列腺癌患者，出现了类似史蒂文斯-约翰逊综合征（SJS）的皮疹。恢复使用派姆单抗诱发的严重皮疹通过皮质类固醇、丙种球蛋白和免疫抑制剂联合治疗成功治愈。早期发现皮肤毒性至关重要，尤其是对于接受多种抗肿瘤治疗的患者。皮肤irAE后，我们应认真对待恢复使用ICI的问题。
