Characterizing immune checkpoint inhibitor-related cutaneous adverse reactions: A comprehensive analysis of FDA adverse event reporting system (FAERS) database

Eosinophil-induced adverse events induced by treatment with programmed cell death 1/ligand 1 inhibitors: A comprehensive disproportionality analysis of the FDA adverse event reporting system

Eosinophil-induced adverse events (Eo-irAEs) have been observed in patients treated with programmed cell death 1/ligand 1 (PD-1/PD-L1) inhibitors. Surprisingly, the clinical features and outcomes of Eo-irAEs induced by PD-1/PD-L1 inhibitors have not yet been elucidated. This study investigated the characteristics of and risk factors for Eo-irAEs induced by PD-1/PD-L1 inhibitors. We extracted data on Eo-irAEs related to PD-1/PD-L1 inhibitors from the FDA Adverse Event Reporting System (FAERS) from 2015 to 2023. Disproportionality and Bayesian analyses were applied for data mining and analysis. A total of 430 Eo-irAEs induced by PD-1/PD-L1 inhibitors were included in this study. Older male patients were found to be at a high risk of developing Eo-irAEs. Cemiplimab (ROR 2.66 [1.38, 5.13]), nivolumab (ROR 1.82 [1.61, 2.05]), and pembrolizumab (ROR 1.35 [1.13, 1.62]) showed stronger signals than the other drugs. Cemiplimab showed higher signals for Eo-irAEs than other PD-1/PD-L1 inhibitors, with an information component (IC) of 1.41 (IC 0.25:0.73). Patients experienced Eo-irAEs within the first 100 days, with a median onset time of 56 (interquartile range: 17.0-169.0) days. Eo-irAEs were more likely to occur in patients with lung (n = 147, 34.83%) and skin tumors (n = 145, 34.36%). Eosinophilia (n = 193, 44.88%), drug reactions with eosinophilia and systemic symptoms (DRESS) (n = 98, 22.79%), and eosinophilic fasciitis (n = 69, 16.05%) were the most common adverse events. Eo-irAEs that were life-threatening or resulted in death comprised 5.15% (n = 21) and 5.39% (n = 22) of the patients. PD-1/PD-L1 inhibitors used across a broad spectrum of cancers are associated with an increased risk of Eo-irAEs, which tend to occur early. Although these complications are rare, clinicians using PD-1/PD-L1 inhibitors should be aware of and monitor these potentially serious adverse events related to Eo-irAEs.

Successful treatment of an elderly patient with lung squamous cell carcinoma by tislelizumab and chemotherapy: a case report with novel imaging findings

The advent of immunotherapy has transformed the therapeutic landscape for inoperable, locally advanced Non-Small cell lung cancer (NSCLC), particularly for lung squamous cell carcinoma (LUSC) with a predominance of negative driver genes. Based on the results of clinical trials such as KEYNOTE-042 and KEYNOTE-407, PD-1/PD-L1 inhibitors are now recognized as the standard of care for first-line or second-line treatment in many countries. Among the 17 immune checkpoint inhibitors sanctioned in China, tislelizumab, a domestically developed PD-1 inhibitor, enjoys broad application. Here, we present a case of a patient with LUSC who attained complete remission by cyst formation with the combination of tislelizumab and chemotherapy. Despite the absence of expression data for this patient, imaging studies revealed a reduction in the primary lesion size and the emergence of an uncommon cystic alteration post-treatment with sequential immunochemotherapy and tislelizumab monotherapy. As per the most recent follow-up, the lesion has vanished entirely. This outcome holds significant implications for the treatment of driver gene-negative LUSC by tislelizumab.

Severe cutaneous drug toxicity following disitamab vedotin treatment for metastatic gastric cancer: a case report

Background

This study reports a case of severe cutaneous toxicity in a patient with metastatic gastric cancer induced by disitamab vedotin, emphasizing the need for careful monitoring and management in such treatments.

Case presentation

A 71-year-old female was admitted to hospital complaining of serious rashes following the first cycle of disitamab vedotin regimen for metastatic gastric cancer. The doctor diagnosedtoxic epidermal necrolysis (TEN) induced by the drug. The patient received high-dose methylprednisolone due to the side effects. This resulted in a gradual improvement of symptoms.

Conclusion

During the use of disitamab vedotin, patients need to be monitored for severe skin toxicity.