Emerging Insights into Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Induced by Immune Checkpoint Inhibitor and Tumor-Targeted Therapy

Overview

Journal J Inflamm Res

Publisher Dove Medical Press

Date 2024 Apr 22

PMID 38645875

Authors

Min Lin

Ting Gong

Shifan Ruan

Xiaoqing Lv

Rongying Chen

Xinhong Su

Bo Cheng

Chao Ji

Affiliations

Soon will be listed here.

Abstract

Objective: Anticancer drugs have revolutionized tumor therapy, with cutaneous toxicities such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) being common immune-related adverse events. The debate over the efficacy of systemic corticosteroids in treating these conditions persists, while tumor necrosis factor (TNF)-alpha inhibitors show promise. This study aims to evaluate the effectiveness and safety of combination therapy involving the TNF-α inhibitor adalimumab for SJS/TEN induced by anticancer drugs.

Methods: A literature review of SJS/TEN cases induced by anticancer drugs from 1992 to 2023 was conducted, alongside an analysis of patients admitted to the First Affiliated Hospital of Fujian Medical University during the same period. Clinical characteristics, skin healing time, mortality, and adverse events were evaluated in two treatment groups: SJS/TEN patients treated with targeted anticancer therapies and immunotherapies.

Results: Among the 27 patients studied (18 with SJS or SJS-TEN overlapping and 9 with TEN), combination therapy with adalimumab significantly reduced mucocutaneous reepithelization time and healing duration compared to corticosteroid monotherapy. Patients receiving adalimumab combined with corticosteroids had lower actual mortality rates than those on corticosteroid monotherapy. The combination therapy also showed a trend towards reducing standardized mortality rates based on the Score of Toxic Epidermal Necrolysis (SCORTEN).

Conclusion: The findings suggest that adalimumab in combination with corticosteroids provides significant clinical benefits and is safer than corticosteroids alone for treating SJS/TEN induced by targeted anticancer therapies and immunotherapies. This study contributes valuable insights into potential treatment strategies for severe cutaneous adverse reactions to anticancer drugs, highlighting the importance of exploring alternative therapies such as TNF-α inhibitors in managing these conditions effectively.

Citing Articles

Superficial mucoceles as a sequel to Stevens‑Johnson syndrome during treatment of cutaneous squamous cell carcinoma with cemiplimab: A case report and review of literature.

Chwialkowska V, Slowinska M, Platkowska A, Kania J, Parciak K, Czarnecka A Exp Ther Med. 2024; 29(1):15.

PMID: 39624595 PMC: 11609618. DOI: 10.3892/etm.2024.12765.

Clinical Features of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Induced by Immune Checkpoint Inhibitor versus Non-Immune Checkpoint Inhibitor Drugs in China: A Cross-Sectional Study and Literature Review.

Qin K, Gong T, Ruan S, Lin M, Su X, Lv X J Inflamm Res. 2024; 17:7591-7605.

PMID: 39464339 PMC: 11512543. DOI: 10.2147/JIR.S491791.

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