Treatment of Tislelizumab-Induced Toxic Epidermal Necrolysis and Agranulocytosis: A Case Report and Literature Review.

IF 1.1 Q4 PHARMACOLOGY & PHARMACY
Yanshi Zhou, Honghao Xue, Chenghua Lu, Yemin Zhang, Qingyuan Wu, Jun Zhang, Shiyun Xie, Xiangqian Xu, Xiaoyan Guo
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引用次数: 0

Abstract

Background: Non-small Cell Lung Cancer (NSCLC) makes up about 85% of lung cancer cases, mainly adenocarcinoma and squamous cell carcinoma. Recently, PD-1 inhibitors have become crucial in NSCLC treatment, significantly enhancing survival for some. However, side effects, like skin reactions and hematotoxicity, limit their use, with drug-induced TEN and immunotherapy-induced agranulocytosis as severe adverse effects.

Case presentation: Herein, we have reported the case of a 75-year-old male diagnosed with metastatic Lung Squamous cell Carcinoma (LUSC) in the left lung. He received first-line treatment with one cycle of tislelizumab in combination with nab-paclitaxel and carboplatin, after which he developed Toxic Epidermal Necrolysis (TEN) and granulocytopenia. To address these two serious immune-related Adverse Events (irAEs), the patient was administered methylprednisolone in combination with gamma globulin for TEN and dexamethasone in combination with G-CSF for agranulocytosis. Antibiotics were also administered according to the patient's medication regimen. After treatment, the patient recovered and was discharged from the hospital. It was also noted that the lung tumor condition improved.

Conclusion: Effective management of severe immune-related side effects from tislelizumab, including TEN and agranulocytosis, can be partly achieved through steroids, gamma globulin, GCSF, and antibiotics. This strategy not only alleviates these adverse effects, but also potentially improves tumor conditions, highlighting the crucial role of vigilant monitoring and management in immunotherapy.

治疗 Tislelizumab 引起的中毒性表皮坏死溶解症和粒细胞减少症:病例报告与文献综述
背景:非小细胞肺癌(NSCLC)约占肺癌病例的85%,主要是腺癌和鳞癌。最近,PD-1抑制剂已成为治疗NSCLC的关键药物,大大提高了部分患者的生存率。然而,皮肤反应和血液毒性等副作用限制了它们的使用,其中药物诱导的TEN和免疫治疗诱导的粒细胞减少症是严重的不良反应:在此,我们报告了一例 75 岁男性患者的病例,他被诊断为左肺转移性肺鳞状细胞癌(LUSC)。他接受了一个周期的替斯利珠单抗联合纳布紫杉醇和卡铂的一线治疗,之后出现了中毒性表皮坏死(TEN)和粒细胞减少症。针对这两种严重的免疫相关不良事件(irAEs),患者接受了甲泼尼龙联合丙种球蛋白治疗 TEN,以及地塞米松联合 G-CSF 治疗粒细胞减少症。此外,还根据患者的用药方案使用了抗生素。治疗后,患者康复出院。同时,肺部肿瘤情况也得到了改善:结论:通过使用类固醇、丙种球蛋白、GCSF 和抗生素,可以有效控制替斯利珠单抗引起的严重免疫相关副作用,包括 TEN 和粒细胞减少。这种策略不仅能减轻这些不良反应,还有可能改善肿瘤状况,突出了免疫疗法中警惕性监测和管理的关键作用。
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来源期刊
Current drug safety
Current drug safety PHARMACOLOGY & PHARMACY-
CiteScore
2.10
自引率
0.00%
发文量
112
期刊介绍: Current Drug Safety publishes frontier articles on all the latest advances on drug safety. The journal aims to publish the highest quality research articles, reviews and case reports in the field. Topics covered include: adverse effects of individual drugs and drug classes, management of adverse effects, pharmacovigilance and pharmacoepidemiology of new and existing drugs, post-marketing surveillance. The journal is essential reading for all researchers and clinicians involved in drug safety.
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