Delayed presentation of pembrolizumab-induced SJS-TEN overlap syndrome.
증례보고
1/5 보강
PICO 자동 추출 (휴리스틱, conf 2/4)
유사 논문P · Population 대상 환자/모집단
환자: prior irAEs
I · Intervention 중재 / 시술
추출되지 않음
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
Despite a SCORTEN score predicting high mortality, aggressive immunosuppressive therapy led to a favorable outcome. This underscores the importance of prolonged vigilance and multidisciplinary management in patients with prior irAEs.
[INTRODUCTION] Immune checkpoint inhibitors (ICIs), such as pembrolizumab, are integral to cancer therapy but can cause severe immune-related adverse events (irAEs), including Stevens-Johnson syndrome
APA
Wells DA, Acton G, Halford Z (2025). Delayed presentation of pembrolizumab-induced SJS-TEN overlap syndrome.. Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners, 10781552251409390. https://doi.org/10.1177/10781552251409390
MLA
Wells DA, et al.. "Delayed presentation of pembrolizumab-induced SJS-TEN overlap syndrome.." Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners, 2025, pp. 10781552251409390.
PMID
41417872
Abstract
[INTRODUCTION] Immune checkpoint inhibitors (ICIs), such as pembrolizumab, are integral to cancer therapy but can cause severe immune-related adverse events (irAEs), including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). These rare, life-threatening reactions typically occur early in treatment, with delayed onset being less commonly reported.
[CASE REPORT] We present a 67-year-old female with triple-negative breast cancer who developed a diffuse, painful rash five months after discontinuing pembrolizumab. Physical exam revealed ∼15% body surface area involvement without mucosal lesions. Biopsy confirmed SJS/TEN overlap. The patient had previously experienced pembrolizumab-induced Grade 2 pneumonitis.
[MANAGEMENT & OUTCOME] Initial treatment with high-dose corticosteroids yielded minimal improvement. Intravenous immunoglobulin (IVIG) was added, resulting in clinical stabilization. The patient was discharged after 11 days with a steroid taper and showed gradual symptom improvement at one-month follow-up.
[DISCUSSION] This case highlights an exceptionally delayed onset of pembrolizumab-induced SJS/TEN overlap, extending known timelines for irAE manifestation. Prior pneumonitis may have predisposed the patient to subsequent cutaneous toxicity. Despite a SCORTEN score predicting high mortality, aggressive immunosuppressive therapy led to a favorable outcome. This underscores the importance of prolonged vigilance and multidisciplinary management in patients with prior irAEs.
[CASE REPORT] We present a 67-year-old female with triple-negative breast cancer who developed a diffuse, painful rash five months after discontinuing pembrolizumab. Physical exam revealed ∼15% body surface area involvement without mucosal lesions. Biopsy confirmed SJS/TEN overlap. The patient had previously experienced pembrolizumab-induced Grade 2 pneumonitis.
[MANAGEMENT & OUTCOME] Initial treatment with high-dose corticosteroids yielded minimal improvement. Intravenous immunoglobulin (IVIG) was added, resulting in clinical stabilization. The patient was discharged after 11 days with a steroid taper and showed gradual symptom improvement at one-month follow-up.
[DISCUSSION] This case highlights an exceptionally delayed onset of pembrolizumab-induced SJS/TEN overlap, extending known timelines for irAE manifestation. Prior pneumonitis may have predisposed the patient to subsequent cutaneous toxicity. Despite a SCORTEN score predicting high mortality, aggressive immunosuppressive therapy led to a favorable outcome. This underscores the importance of prolonged vigilance and multidisciplinary management in patients with prior irAEs.