Oral mucosal adverse events following administration of an immune checkpoint inhibitor: a case report

Area of Science:

• Oncology
• Immunology
• Dermatology

Background:

• Immune checkpoint inhibitors (ICIs) like pembrolizumab are vital in cancer therapy.
• Oral immune-related adverse events (irAEs) are emerging complications of ICI treatment.
• Cutaneous melanoma is a common indication for pembrolizumab therapy.

Purpose of the Study:

• To report a case of oral irAEs in a patient treated with pembrolizumab for cutaneous melanoma.
• To highlight the clinical presentation and successful management of these oral complications.
• To emphasize the importance of oral healthcare provider involvement in managing ICI therapy.

Main Methods:

• A case report detailing the clinical course of a patient receiving pembrolizumab.
• Documentation of oral adverse events, including oral lichenoid hypersensitivity reactions, oral candidiasis, and angular cheilitis.
• Description of the therapeutic interventions used for management.

Main Results:

• The patient developed multiple oral irAEs during pembrolizumab therapy.
• Successful resolution of oral symptoms was achieved with topical dexamethasone, nystatin rinses, and systemic fluconazole.
• No delays or discontinuation of oncologic treatment were necessitated by the oral complications.

Conclusions:

• Oral complications are potential risks associated with pembrolizumab therapy.
• Close monitoring and prompt management by oral healthcare providers are essential for patients on ICIs.
• Effective management of oral irAEs can preserve oral health and support uninterrupted cancer treatment.