Macular‐type cutaneous adverse reaction due to atezolizumab and pembrolizumab

Anti-PD-1/PD-L1 targeted therapy is widely used for the treatment of various intractable malignancies and develops therapeutic option in frontier fields oncology treatment. On contrary, these immune checkpoint therapies sometimes develop undesirable adverse reaction as results activation to organs. Herein, we report a case cutaneous reactions during PD-1/PD-L1 both atezolizumab pembrolizumab patient with lung cancer. Dear Editor, Anti-PD-1-/PD-L1-targeted treatment.1, 2 an result organs.3, 4 A representative treatment-mediated reaction.3 PD-1-/PD-L1-targeted 68-year-old man noticed erythematous plaques papules on his trunk extremities days after first administration right adenocarcinoma clinical stage IV, skin eruption gradually developed. physical examination, were localized without involvement mucosal membrane (Figure 1A). biopsy revealed liquefaction spongiosis epidermis lymphocyte infiltration dermis 1B). After antihistamine agent, topical application betamethasone dipropionate, discontinuation additional atezolizumab, was improved recurrence eruption. As alternative cancer, next administrated; however, he again recognized 1C). The second time more spread whole body. that inflammatory interface 1D). administration, several days. One unique characteristics this cause similar by different action point treatment, PD-1 PD-L1. Although detailed molecular mechanism remains unclear our case, thought 3 possible mechanisms pembrolizumab. reason have same additives drug, such L-histidine, white soft sugar, polysorbate. In particular, polysorbate includes drugs influenza vaccine known allergic some cases.5, 6 Therefore, speculated might be enhanced another drug contribution reaction. However, ordinally continued intake acetaminophen third become trigger autoimmune-like Because relatively mild form corticosteroid oral it seemed easy recover even if autoimmunity-related Taken together, clinicians should keep mind occur switching into anti-PD-1-/PD-L1-related inhibitor. Approval research protocol: No human participant involved study. Informed Consent: N/A. Registry Registration No. study/trial: Animal Studies: authors declare no conflicts interest.