Nivolumab‐induced bullous pemphigoid after radiotherapy and abscopal effect

Grimaux, Xavier; Delva, R.; Jadaud, É.; Croué, Anne

doi:10.1111/ajd.12987

Cited by 19 publications

(11 citation statements)

References 4 publications

(4 reference statements)

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“…At onset, the disease involved area of irradiation in 93% of patients and, subsequently, became generalized in 41% [ 110 ]. RT has been reported to trigger BP in association with anti-PD1 antibody nivolumab [ 112 , 113 , 114 ].…”

Section: Trigger Factorsmentioning

confidence: 99%

Bullous Pemphigoid: Trigger and Predisposing Factors

et al. 2020

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Bullous pemphigoid (BP) is the most frequent autoimmune subepidermal blistering disease provoked by autoantibodies directed against two hemidesmosomal proteins: BP180 and BP230. Its pathogenesis depends on the interaction between predisposing factors, such as human leukocyte antigen (HLA) genes, comorbidities, aging, and trigger factors. Several trigger factors, such as drugs, thermal or electrical burns, surgical procedures, trauma, ultraviolet irradiation, radiotherapy, chemical preparations, transplants, and infections may induce or exacerbate BP disease. Identification of predisposing and trigger factors can increase the understanding of BP pathogenesis. Furthermore, an accurate anamnesis focused on the recognition of a possible trigger factor can improve prognosis by promptly removing it.

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Section: Trigger Factorsmentioning

confidence: 99%

Bullous Pemphigoid: Trigger and Predisposing Factors

et al. 2020

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“…To our knowledge, BP is a rare cutaneous irAE and there are 16 previous cases of BP developing during nivolumab-therapy [3][4][5][6][7] . In oncologic patients, BP may be idiopathic, paraneoplastic or related to medication, including cancer therapy.…”

Section: Discussionmentioning

confidence: 99%

Bullous pemphigoid induced by nivolumab in a patient with malignant melanoma

Adachi

Yokoyama²,

Yamagami³

et al. 2020

Trends Immunother

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Immune checkpoint inhibitors, such as nivolumab, have been recognized that the enhanced immune responses often lead to immune-related adverse events (irAEs) in various organs. Although cutaneous toxicity is one of the most common irAEs, bullous pemphigoid (BP) with immune checkpoint inhibitors is rare. Herein, the authors report a case of BP in a patient of the metastatic malignant melanoma of the brain under the treatment of nivolumab. It is notable that this case showed the clear correlation between the status of using of nivolumab and serum levels of anti-BP180 antibody. In addition, the skin eruptions in the case were mainly pruritic erosive or crusted papules and these clinical features may be the clinical characteristics of BP induced by nivolumab.

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“…The abscopal effect, which was first reported by Mole in 1953, is induced by local radiotherapy and shows the regression of non‐irradiated metastatic lesions that are distant from the irradiated site 12 . Although it is a rare phenomenon, to the best of our knowledge, there are five case reports on metastatic RCC treated with a combination of ICI and EBRT 3–7 . The exact mechanisms of abscopal effect have not been elucidated, but some are evident in recent studies 13,14 .…”

Section: Discussionmentioning

confidence: 99%

“…The primary application of conventional EBRT is in palliation of metastatic sites and local tumor growth. The phenomenon of tumor regression in distant lesions from the irradiated site is known as the “abscopal effect.” Although the abscopal effect is a rare phenomenon, to the best of our knowledge, there are five case reports on metastatic RCC treated with a combination of ICI and EBRT 3–7 . Such combination therapies are likely to provide optimal treatment options for advanced RCC.…”

Section: Introductionmentioning

confidence: 99%

Possible abscopal effect after discontinuation of nivolumab in metastatic renal cell carcinoma

Nakajima

Kano

Oda³

et al. 2020

IJU Case Reports

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Introduction Renal cell carcinoma has been considered radioresistant. Recently, several studies have reported the efficacy of combination therapy using radiotherapy and immune checkpoint inhibitors. Case presentation In 1999, a 56‐year‐old woman underwent left nephrectomy (clear cell carcinoma, pT1bN0M0). Seventeen years postoperatively, recurrence in the left lung hilum was observed. Despite administration of three molecular target drugs, all treatments were terminated due to adverse events. Nivolumab was initiated in December 2016. In August 2017, subcutaneous and lung metastases were observed. Moreover in January 2018, right renal metastasis was noted. After 22 cycles of nivolumab treatment, metastasis in the iliac bone was observed, and the patient was subjected to conventional palliative external beam radiation therapy. Five months after radiotherapy, there was significant reduction in multiple metastases. Here, we reported the case presenting with possible abscopal effect. Conclusion Radiotherapy combined with immune checkpoint inhibitors may induce systemic effects against metastatic renal carcinoma.

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Nivolumab‐induced bullous pemphigoid after radiotherapy and abscopal effect

Cited by 19 publications

References 4 publications

Bullous Pemphigoid: Trigger and Predisposing Factors

Bullous Pemphigoid: Trigger and Predisposing Factors

Bullous pemphigoid induced by nivolumab in a patient with malignant melanoma

Possible abscopal effect after discontinuation of nivolumab in metastatic renal cell carcinoma

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