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Case report: Alpelisib-induced Stevens–Johnson syndrome
Frontiers in Oncology ( IF 3.5 ) Pub Date : 2022-09-28 , DOI: 10.3389/fonc.2022.954027
Christine Jane Kurian 1 , Akshay Desai 2 , William Rafferty 3 , Ahmed Kamel Abou Hussein 1
Affiliation  

Background

Alpelisib is a recently approved treatment for hormone receptor-positive, HER2-negative, PIK3CA-mutated advanced breast cancer. It has been associated with alopecia and rash, but there are no documented cases of Stevens–Johnson Syndrome (SJS) associated with this drug. Here, we detail the first case of SJS associated with alpelisib.

Case description

Our patient is a 60-year-old woman with a past medical history of metastatic hormone receptor-positive (ER+ 80% and PR+ 1%), HER2-negative metastatic breast cancer who presented with acute odynophagia, fevers, and diffuse body rash after receiving her first doses of alpelisib and fulvestrant in the preceding days. She presented to the emergency department after developing a whole-body rash and severe ulceration of her buccal mucosa. She was started on methylprednisolone with remarkable improvement in symptoms.

Conclusion

This case report details the only report of SJS following alpelisib treatment. Immediate cessation of drugs and initiation of steroids are the cornerstone of treatment. Patients who experience such side effects will have to be monitored closely for long-term sequelae associated with SJS, including cutaneous, ocular, and oral sequelae, all of which can profoundly affect the quality of life for cancer patients.



中文翻译:

病例报告:Alpelisib 诱导的 Stevens-Johnson 综合征

Background

Alpelisib 是一种最近获批的治疗激素受体阳性、HER2 阴性、PIK3CA 突变的晚期乳腺癌的药物。它与脱发和皮疹有关,但没有与这种药物相关的史蒂文斯-约翰逊综合征 (SJS) 病例记录。在这里,我们详细介绍了与 alpelisib 相关的第一例 SJS。

Case description

我们的患者是一位 60 岁的女性,既往有转移性激素受体阳性(ER+80% 和 PR+1%)、HER2 阴性转移性乳腺癌病史,术后出现急性吞咽痛、发热和弥漫性全身皮疹。在前几天接受了她的第一剂 alpelisib 和氟维司群。她在出现全身皮疹和颊粘膜严重溃疡后到急诊室就诊。她开始服用甲基强的松龙,症状明显改善。

Conclusion

该病例报告详细介绍了alpelisib治疗后唯一的SJS报告。立即停药和开始使用类固醇是治疗的基石。出现此类副作用的患者必须密切监测与 SJS 相关的长期后遗症,包括皮肤、眼部和口腔后遗症,所有这些都会严重影响癌症患者的生活质量。

更新日期:2022-09-28
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