Zhao Luping, Cheng Zhen, Li Piaopiao
Department of Pharmacy, Dongyang People's Hospital, Dongyang, Zhejiang, China.
Department of Medical Oncology, Dongyang People's Hospital, Dongyang, Zhejiang, China.
Front Oncol. 2025 Aug 27;15:1596818. doi: 10.3389/fonc.2025.1596818. eCollection 2025.
Toripalimab in combination with cisplatin and paclitaxel is indicated as a first-line treatment for metastatic esophageal squamous cell carcinoma (ESCC). Toripalimab, a PD-1 inhibitor, commonly causes immune-related adverse reactions such as immune-related rash, immune-related pneumonitis, and immune-related diarrhea and colitis. This study reports a case of toripalimab-induced exacerbation of psoriasis in an esophageal cancer patient, emphasizing the need for careful monitoring and management in such treatments.
A 60-year-old male patient with a history of well-controlled psoriasis without medication and no other significant medical conditions was hospitalized due to recurrence and exacerbation of psoriasis following two cycles of Toripalimab combined with cisplatin and nab-paclitaxel therapy after esophageal malignancy surgery. The psoriasis flare-up was considered to be induced by Toripalimab. After admission, the patient was treated with high-dose methylprednisolone. Upon symptom control, the steroid dosage was gradually tapered and completely discontinued over a total course of approximately eight weeks, with no recurrence throughout the tapering and discontinuation period.
For cancer patients with pre-existing autoimmune diseases, particularly those with psoriasis, comprehensive multidisciplinary evaluation is essential before initiating Toripalimab therapy. During immunotherapy cycles, specialized follow-up by dermatologists and clinical pharmacists is recommended to monitor the status of pre-existing dermatological conditions and potential adverse reactions.
托瑞帕利单抗联合顺铂和紫杉醇被批准用于转移性食管鳞状细胞癌（ESCC）的一线治疗。托瑞帕利单抗是一种PD-1抑制剂，常引起免疫相关不良反应，如免疫相关皮疹、免疫相关肺炎以及免疫相关腹泻和结肠炎。本研究报告了1例食管癌患者在使用托瑞帕利单抗后银屑病加重的病例，强调在此类治疗中进行仔细监测和管理的必要性。
一名60岁男性患者，有银屑病病史，此前病情控制良好，无需药物治疗，无其他重大疾病史。因食管癌手术后接受两个周期的托瑞帕利单抗联合顺铂和白蛋白结合型紫杉醇治疗后银屑病复发并加重而住院。银屑病发作被认为是由托瑞帕利单抗引起的。入院后，患者接受了大剂量甲泼尼龙治疗。症状得到控制后，逐渐减少类固醇剂量，并在大约8周的总疗程中完全停药，在减量和停药期间均未复发。
对于患有自身免疫性疾病，尤其是银屑病的癌症患者，在开始托瑞帕利单抗治疗前进行全面的多学科评估至关重要。在免疫治疗周期中，建议皮肤科医生和临床药师进行专门随访，以监测既往皮肤病状况和潜在不良反应的情况。
