Severe erythema exudative multiforme developing from advanced melanoma treated with dabrafenib and trametinib followed by nivolumab

HLA‐DRB1*04:05 in two cases of Vogt–Koyanagi–Harada disease‐like uveitis developing from an advanced melanoma patient treated by sequential administration of nivolumab and dabrafenib/trametinib therapy

“…One of the possible mechanisms for this phenomenon is that melanoma-related antigens provided by dabrafenib/ trametinib may enhance both anti-melanoma responses and autoimmune responses. Indeed, both of the two cases achieved biological CR and, moreover, case 2 developed severe erythema exudative multiforme, 8 which is also a rare AE in dabrafenib/trametinib therapy, 3 months before the development of uveitis. Because this report presents only two cases, further cases are needed to clarify this hypothesis.…”

“…A 35‐year‐old Japanese woman that we reported in the Journal of Dermatology 2017 developed uveitis 4 months after the development of severe erythema exudative multiforme. After the treatment with oral prednisolone, we administrated nivolumab at 2 mg/kg every 3 weeks for 24 weeks.…”

Intensity-Modulated Radiotherapy Triggers Onset of Bullous Pemphigoid in a Patient with Advanced Melanoma Treated with Nivolumab

“…On the other hand, the efficacy of ipilimumab in nivolumab-resistant advanced melanoma is only 3.6% [ 3 ], suggesting that additional supportive therapy for anti-PD-1 antibody is needed for nivolumab-resistant advanced melanoma. Indeed, although several supportive therapies to enhance the antitumor immune response of anti-PD-1 antibodies have already been reported [ 3 , 4 , 5 , 6 , 7 , 8 ], unexpected immune-related adverse events were detected at the same time [ 8 ]. In this report, we describe a patient with advanced melanoma treated with nivolumab followed by intensity-modulated radiotherapy (IMRT), which might have triggered bullous pemphigoid (BP).…”

Treatment of Advanced Melanoma: Past, Present and Future

“…Moreover, two independent case reports about severe rhabdomyolysis caused by ICIs followed by D + T combination therapy for advanced melanoma were reported [43,48]. In addition, nivolumab followed by D + T combination therapy can cause severe drug eruption such as exudative erythema multiforme [49]. Those reports suggest that the subsets and incident ratio of severe adverse events (SAEs) caused by BRAF/MEK inhibitors might differ from those in previously published clinical studies in the real world.…”