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Granulocyte-dependent Autoantibody-induced Skin Blistering

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Pembrolizumab-Induced Immune-Mediated Glossitis.

Alwin Alias¹, James A Hall¹, Pruthali Kulkarni²

¹Hematology and Medical Oncology, Baylor Scott & White Medical Center, Temple, USA.

|March 4, 2022

Summary

Pembrolizumab, an anti-PD-1 therapy, can cause immune-related adverse events (IRAEs). This case highlights rare oral glossitis in a lung cancer patient treated with pembrolizumab, successfully managed with prednisone.

Keywords:

chemotherapy corticosteroids immune-mediated glossitis immunotherapy keytruda pembrolizumab prednisolone

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Published on: December 15, 2011

Area of Science:

Oncology
Immunotherapy
Dermatology

Background:

Pembrolizumab (Keytruda) is an anti-PD-1 antibody used to treat various cancers.
Immune-related adverse events (IRAEs) are known side effects affecting multiple organ systems.
While skin manifestations are common, oral mucosal adverse events are rarely reported with PD-1/PD-L1 inhibitors.

Observation:

A 71-year-old male with newly diagnosed lung squamous cell carcinoma received pembrolizumab.
The patient developed tongue ulcerations consistent with glossitis.
The oral condition was suspected to be an immune-related adverse event.

Findings:

The patient was treated with oral prednisone (40 mg initially, with a weekly 10 mg taper).
Significant symptom improvement was observed after one month of treatment.
This suggests a potential treatment protocol for pembrolizumab-induced glossitis.

Implications:

Highlights the importance of recognizing rare oral IRAEs associated with PD-1 inhibitors.
Demonstrates the efficacy of corticosteroid treatment for pembrolizumab-induced glossitis.
Contributes to understanding the safety profile of immunotherapy in lung cancer treatment.