Eosinophilic fasciitis induced by nivolumab therapy managed without treatment interruption or systemic immunosuppression

Eosinophilic Fasciitis with Concurrent Necrobiotic Granulomatous Dermatitis Related to Checkpoint Inhibition Therapy

“…[7] Literature review also revealed eight cases of EF in association with nivolumab and one other in association with ipilimumab. [6,8,9] In seven of eight cases the offending agent was discontinued. [6,[8][9][10] Of the cases that reported treatment, six of seven initiated immunosuppressive therapy with steroids and five of seven also initiated a second agent such as methotrexate, mycophenolate mofetil, and/or cyclosporine.…”

“…[6,8,9] In seven of eight cases the offending agent was discontinued. [6,[8][9][10] Of the cases that reported treatment, six of seven initiated immunosuppressive therapy with steroids and five of seven also initiated a second agent such as methotrexate, mycophenolate mofetil, and/or cyclosporine. [6,[8][9][10] Although no treatment guidelines have been established, glucocorticoids are considered first-line.…”

“…[6,[8][9][10] Of the cases that reported treatment, six of seven initiated immunosuppressive therapy with steroids and five of seven also initiated a second agent such as methotrexate, mycophenolate mofetil, and/or cyclosporine. [6,[8][9][10] Although no treatment guidelines have been established, glucocorticoids are considered first-line. [6] There is no established ''second-line treatment'' but methotrexate, mycophenolate mofetil, cyclosporine, and infliximab have all been described in literature often used in combination with steroids.…”

Disappearance of MMR-deficient subclones after controlled IL-12 and PD-1 inhibition in a glioma patient

“… 10 One patient on ipilimumab for metastatic melanoma even developed granulomas in the sella turcica. 11 While the significance of plasma cells in the context of checkpoint inhibitors and Controlled IL-12 is unclear, eosinophilic inflammation has repeatedly been described in response to checkpoint inhibitors, 12 , 13 and eosinophilia may correlate with treatment response. 14 …”