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A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis

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Case report: Envafolimab causes local skin necrosis.

Jing Jing Liu¹, Xiao Ya Xu¹, Huan Han²

¹Yu Lin City First Hospital (Yan An University Second Affiliated Hospital) Pharmaceutical Department, Yu Lin, Shaanxi, China.

Frontiers in Immunology

|April 8, 2024

Summary

Envafolimab, a novel PD-L1 inhibitor, showed potential for treating advanced solid tumors. However, a case report highlights severe injection site skin necrosis and bleeding, necessitating further safety studies for subcutaneous administration.

Keywords:

PD-L1 adverse drug reaction case report envafolimab humanized monoclonal antibody skin necrosis subcutaneous

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Area of Science:

Immunotherapy
Oncology
Pharmacology

Background:

Envafolimab is a novel fusion protein targeting programmed death-ligand 1 (PD-L1) for subcutaneous injection.
It received conditional market authorization in China for specific advanced solid tumors.
Limited post-marketing data necessitates further investigation into its safety and efficacy.

Observation:

A patient with hepatocellular carcinoma developed severe skin necrosis and bleeding at the injection site after receiving envafolimab.
This adverse event occurred following subcutaneous administration of the PD-L1 inhibitor.

Findings:

Subcutaneous administration of envafolimab may trigger immune-mediated mechanisms leading to local skin necrosis.
The case highlights a potential, severe adverse reaction associated with this route of administration.

Implications:

Clinicians should exercise caution and consider potential risks before subcutaneous PD-L1 inhibitor administration.
Further clinical studies are crucial to establish the safety profile and therapeutic guidelines for envafolimab.
Understanding immune-related adverse events is vital for optimizing cancer immunotherapy strategies.