Psoriasis induced by first‑line pembrolizumab in metastatic non‑small cell lung cancer: A case report

Gatti,Federica; Caruso,Gianluca; Potenza,Concetta; Santini,Daniele; Petrozza,Vincenzo; Annetta,Alessandro; Ceddia,Serena; Cosimati,Antonella; Brandi,Martina; Sorrentino,Veronica; Proietti,Ilaria; Rossi,Luigi

doi:10.3892/ol.2023.13897

Psoriasis induced by first‑line pembrolizumab in metastatic non‑small cell lung cancer: A case report

Authors:
- Federica Gatti
- Gianluca Caruso
- Concetta Potenza
- Daniele Santini
- Vincenzo Petrozza
- Alessandro Annetta
- Serena Ceddia
- Antonella Cosimati
- Martina Brandi
- Veronica Sorrentino
- Ilaria Proietti
- Luigi Rossi
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Affiliations: Department of Clinical and Molecular Medicine, ‘Sapienza’ University of Rome, I‑00185 Rome, Italy, Department of Medico-Surgical Sciences and Biotechnologies, Pathology Unit, ICOT Hospital, ‘Sapienza’ University of Rome, I‑04100 Latina, Italy, Dermatology Unit ‘Daniele Innocenzi’, Department of Medical‑Surgical Sciences and Bio‑Technologies, ‘Sapienza’ University of Rome, Fiorini Hospital, I‑04019 Terracina, Italy, Multispeciality Department of Oncology, ASL Latina, ‘Sapienza’ University of Rome, I‑04011 Aprilia, Italy, Department of Medico-Surgical Sciences and Biotechnologies, Pathology Unit, ICOT Hospital, ‘Sapienza’ University of Rome, I‑04100 Latina, Italy, Dermatology Unit ‘Daniele Innocenzi’, Department of Medical‑Surgical Sciences and Bio‑Technologies, ‘Sapienza’ University of Rome, Fiorini Hospital, I‑04019 Terracina, Italy, Department of Oncology, Hospital Dono Svizzero of Formia, I‑04023 Formia, Italy
Published online on: June 2, 2023 https://doi.org/10.3892/ol.2023.13897
Article Number: 311

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Abstract

Therapeutic options for non‑small cell lung cancer (NSCLC) have changed with the introduction of immune checkpoint inhibitors. Immunotherapy is generally well tolerated, but can also be associated with severe adverse events, such as the development of new autoimmune diseases. In patients without a history of autoimmune diseases, psoriasis caused by immunotherapy treatment is rarely described in the literature. The present study describes the case of a 68‑year‑old man with metastatic NSCLC that started chemoimmunotherapy with carboplatin plus pemetrexed plus pembrolizumab. After two cycles of therapy, the patient developed a G3 maculopapular rash. Biopsy confirmed psoriasis and pembrolizumab treatment was discontinued. At the last follow up, the patient was still on maintenance therapy with pemetrexed alone, which is well tolerated. Psoriasis has rarely been reported as an immune‑related adverse event. Although the patient had to stop the immunotherapy treatment, the patient is still exhibiting a response to it. Notably, it has previously been described how skin toxicities are associated with a better outcome. Other studies need to be conducted to identify the risk and predictive factors associated with severe immune adverse events and objective response.

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