scholarly journals Stevens-Johnson Syndrome–Like Reaction After Exposure to Pembrolizumab and Recombinant Zoster Vaccine in a Patient With Metastatic Lung Cancer

2020 ◽  
Vol 8 ◽  
pp. 232470962091479 ◽  
Author(s):  
Ivy Riano ◽  
Cagney Cristancho ◽  
Thomas Treadwell
Keyword(s):  
Lung Cancer ◽  
Late Onset ◽  
Treatment Strategies ◽  
Skin Toxicity ◽  
Stevens Johnson Syndrome ◽  
Cancer Therapies ◽  
Zoster Vaccine ◽  
Johnson Syndrome ◽  
Recombinant Zoster Vaccine ◽  
Immunological Pathogenesis

Stevens-Johnson syndrome (SJS) is a life-threating mucocutaneous reaction predominantly induced by drugs. Targeted cancer therapies such as pembrolizumab, which has been approved for the treatment of metastatic malignancy, can cause severe skin toxicities, including SJS. They are rare and inconsistently reported. In this article, we report the case of a 80-year-old woman with metastatic non–small cell lung cancer who had a SJS-like eruption involving oral mucosa after 15 weeks of exposure of pembrolizumab (6 doses) and 7 days after 1 dose of recombinant zoster vaccine. SJS is a rare blistering disorder with high mortality rate and significant morbidity. Causes include drugs, herpes viruses, and immunization. The timing of the eruption soon after the receipt of recombinant zoster vaccine suggests a role of vaccination in our patient, yet patients receiving cancer immunotherapy may develop late-onset skin toxicity. Therefore, we recommend long-term monitoring for mucocutaneous reactions after initiation of pembrolizumab. Further research is needed to characterize the immunological pathogenesis and improve timely recognition and treatment strategies.

Late onset imatinib-induced Stevens–Johnson syndrome

2014 ◽  
Vol 20 (6) ◽  
pp. 476-478 ◽  
Author(s):  
Evan Bois ◽  
Lisa M Holle ◽  
Umar Farooq
Keyword(s):  
Late Onset ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome

Afatinib-associated Stevens-Johnson syndrome in an EGFR-mutated lung cancer patient

Lung Cancer ◽  
2016 ◽  
Vol 95 ◽  
pp. 35-38 ◽  
Author(s):  
Janine Doesch ◽  
Dirk Debus ◽  
Christian Meyer ◽  
Thomas Papadopoulos ◽  
Erwin S Schultz ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patient ◽  
Lung Cancer Patient ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Egfr Mutated

Pediatric SJS/TEN Subdued by a Combination of Dexamethasone, Cyclosporine, and Etanercept

2019 ◽  
Vol 23 (5) ◽  
pp. 547-550 ◽  
Author(s):  
Jérôme Coulombe ◽  
Eugénie Belzile ◽  
Amélie Duhamel ◽  
Pauline Rault ◽  
Chantal Buteau ◽  
...  
Keyword(s):  
Drug Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Triple Therapy ◽  
Late Onset ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome

We report a case of an 17-year-old male with a drug reaction in the spectrum of Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), triggered by carbamazepine, who was succesfully treated with the combination of dexamethasone, cyclosporine, and etanercept. This triple therapy halted and prevented skin epidermolysis without immediate or late onset complications.

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

2021 ◽  
Vol 12 ◽  
Author(s):  
Caterina Gianni ◽  
Giuseppe Bronte ◽  
Angelo Delmonte ◽  
Marco Angelo Burgio ◽  
Kalliopi Andrikou ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Tyrosine Kinase ◽  
Lung Adenocarcinoma ◽  
Therapeutic Strategy ◽  
New Drugs ◽  
Short Exposure ◽  
Stevens Johnson Syndrome ◽  
High Dose ◽  
Johnson Syndrome ◽  
Egfr Mutated

Background: Lung cancer is a complex disease with many subtypes. However, histochemical characteristics, and genetic mutation determinations are contributing to better define therapeutic targets and new drugs. Although this guarantees patients the possibility of obtaining tailored treatment, it makes it more difficult for clinicians patient management more difficult for clinicians who have to define the most suitable therapeutic strategy and to deal with new treatment-related adverse events (TRAEs). It has been seen that the administration of a tyrosine kinase inhibitor (TKI) sequential to an immune checkpoint inhibitor (ICI) can lead to a higher rate of severe and life-threatening TRAEs. We report the case of a patient with advanced non-small cell lung cancer (NSCLC) who experienced severe hepatotoxicity and Stevens-Johnson syndrome (SJS) induced by osimertinib sequential to pembrolizumab.Case presentation: A 54-year-old woman with advanced NSCLC received one cycle of chemotherapy plus pembrolizumab after diagnosis. Ten days later she began osimertinib 80 mg daily because epidermal growth factor receptor (EGFR) analysis had revealed an exon 19 deletion. On day 23 of osimertinib the patient experienced an episode of grade (G) 3 hepatotoxicity resolved by discontinuing osimertinib and corticosteroid therapy. The patient restarted osimertinib 80 mg daily after the remission of symptoms but was hospitalized 14 days later following a second episode of severe G3 hepatotoxicity and the onset of SJS, successfully treated with high-dose corticosteroids. Despite the short exposure to osimertinib, the patient obtained a good pathological response.Conclusion: It is important to alert clinicians to carefully evaluate the sequential therapeutic strategy in patients with NSCLC who are candidates for TKI- or ICI-based treatment. Our experience suggests that the use of tyrosine kinase inhibitors (TKIs) as front-line treatment is a more reasonable and safe option for EGFR-mutated lung adenocarcinoma, with ICIs considered as a possible further treatment in sequential approaches.

scholarly journals Nivolumab-associated Stevens-Johnson syndrome in a patient with lung cancer

2021 ◽  
Vol 27 (3) ◽  
Author(s):  
Tamara Gracia-Cazaña ◽  
Esteban Padgett ◽  
Verónica Calderero ◽  
Rosa Oncins
Keyword(s):  
Lung Cancer ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome

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

2019 ◽  
Vol 25 (8) ◽  
pp. 2052-2055 ◽  
Author(s):  
Constantin A Dasanu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Side Effects ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Late Onset ◽  
Checkpoint Inhibitor ◽  
Stevens Johnson Syndrome ◽  
Erythematous Rash ◽  
Immunoglobulin G4 ◽  
Johnson Syndrome

Nivolumab is a fully human immunoglobulin G4 immune checkpoint inhibitor antibody approved for use in the treatment of several malignancies. Severe side effects such as Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) have only extremely rarely been reported with this drug. We present herein a patient who developed SJS after 16 weeks of therapy with nivolumab. A week prior to this event, he developed a pruriginous papulo-erythematous rash. Prompt recognition of this phenomenon, immune checkpoint inhibitor discontinuation and steroid therapy are necessary steps in order to avoid dismal outcomes.

scholarly journals Stevens-Johnson Syndrome Induced by Pembrolizumab in a Lung Cancer Patient

2018 ◽  
Vol 13 (11) ◽  
pp. 1798-1799 ◽  
Author(s):  
Naoki Haratake ◽  
Tetsuzo Tagawa ◽  
Fumihiko Hirai ◽  
Gouji Toyokawa ◽  
Reiko Miyazaki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patient ◽  
Lung Cancer Patient ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome
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