Pembrolizumab-Associated Adverse Events

Immunotherapy-Related Adverse Events

• The National Comprehensive Cancer Network (NCCN) guidelines report that the most common adverse events associated with pembrolizumab include fatigue, pruritus, diarrhea, decreased appetite, constipation, nausea, rash, fever, cough, dyspnea, and musculoskeletal pain 1, 2
• Pembrolizumab can be associated with immune-mediated adverse events, including colitis, hepatitis, endocrinopathies, pneumonitis, or nephritis 1, 2
• Skin-related immune-mediated adverse events can include rash, pruritus, and less common manifestations such as alopecia areata 3

Management of Skin-Related Adverse Events

• The treatment of immune-mediated skin reactions is primarily based on the severity and can range from topical corticosteroids for mild reactions to systemic corticosteroids for more severe cases 3
• For grade 4 dermatologic adverse events, Stevens-Johnson syndrome/toxic epidermal necrolysis, or DRESS syndrome, permanent discontinuation of immunotherapy is required 3
• Dermatologic evaluations are recommended for patients with a history of immune-related skin disorders such as psoriasis, bullous pemphigoid, or lupus 3