Introduction
Nivolumab, an anti-programmed death-1 (PD-1) antibody, is an immune
checkpoint inhibitor. According to the results of the CheckMate-141
study, which compared nivolumab and a physician-selected treatment
modality for recurrent/metastatic head and neck squamous cell carcinoma
with a history of chemotherapy including platinum, nivolumab
significantly increases the overall survival rate1.
Considering the results of this report, nivolumab was approved in the
United States in November 2016 and in Japan in March 2017 as a treatment
modality for patients with recurrent/metastatic head and neck cancer,
who had been previously treated with platinum-containing drugs.
Currently, the clinical benefits of nivolumab therapy have been
recognized not only in head and neck cancers but also in other types of
cancers such as malignant melanoma, non-small cell lung cancer, renal
cell cancer, gastric cancer, and Hodgkin’s lymphoma. Various
immune-related adverse events associated with nivolumab have been
reported, because the mechanism of action of the drug is different from
that of conventional anticancer drugs. However, the frequency of severe
skin complications is considerably less.
Toxic epidermal necrosis (TEN) is a disease with fever and widespread
erythema, erosion, blisters, mucosal rash on the skin. TEN is a rare,
albeit serious disease with a mortality rate of approximately 30%2. We herein report a patient with squamous cell
carcinoma of the tongue who developed TEN after nivolumab treatment.