Literature analysis of tislelizumab-induced Stevens-Johnson syndrome and toxic epidermal necrolysis

HAN Rui; SHEN Mingxi; YANG Hua; JI Zhaoshuai

doi:10.6039/j.issn.1001-0408.2025.16.16

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Literature analysis of tislelizumab-induced Stevens-Johnson syndrome and toxic epidermal necrolysis

更新时间：2025-09-25

- Literature analysis of tislelizumab-induced Stevens-Johnson syndrome and toxic epidermal necrolysis
- ZHONGGUO YAOFANG Vol. 36, Issue 16, Pages: 2046-2050(2025)
- 作者机构：
  
  1.清华大学医院药剂科，北京　100084
  2.津药达仁堂集团股份有限公司第六中药厂质量技术部，天津　300401
  3.清华大学北京清华长庚医院药剂科，北京　102218
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.16.16
  CLC： R979.1
- Received：20 March 2025，
  
  Revised：2025-07-24，
  
  Accepted：25 July 2025，
  
  Published：30 August 2025
- 稿件说明：
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韩锐,沈明曦,杨华,等.替雷利珠单抗致史-约综合征和中毒性表皮坏死松解症的文献分析[J].中国药房,2025,36(16):2046-2050.

HAN Rui,SHEN Mingxi,YANG Hua,et al.Literature analysis of tislelizumab-induced Stevens-Johnson syndrome and toxic epidermal necrolysis[J].ZHONGGUO YAOFANG,2025,36(16):2046-2050.
韩锐,沈明曦,杨华,等.替雷利珠单抗致史-约综合征和中毒性表皮坏死松解症的文献分析[J].中国药房,2025,36(16):2046-2050. DOI： 10.6039/j.issn.1001-0408.2025.16.16.

HAN Rui,SHEN Mingxi,YANG Hua,et al.Literature analysis of tislelizumab-induced Stevens-Johnson syndrome and toxic epidermal necrolysis[J].ZHONGGUO YAOFANG,2025,36(16):2046-2050. DOI： 10.6039/j.issn.1001-0408.2025.16.16.

摘要

目的

分析替雷利珠单抗致史-约综合征（SJS）、中毒性表皮坏死松解症（TEN）的临床特点，为临床用药安全提供参考。

方法

检索中国知网、维普网、万方数据、PubMed、ScienceDirect、Embase等数据库，收集替雷利珠单抗致SJS/TEN的个案报道并进行描述性分析。

结果

共纳入17篇文献，共计17例患者，包括SJS 4例、TEN 13例。17例患者中，男性10例、女性7例，70～79岁者12例，肿瘤类型以肺癌为主（10例），13例患者联用了化疗药物；SJS/TEN的中位发生时间为26（4，104）d，9例患者为首次给药后发生SJS/TEN；16例患者出现前驱性皮疹症状，主要特征为皮肤剥落等严重皮肤损害，伴黏膜损伤。16例患者经对症治疗后好转，1例患者死亡。

结论

替雷利珠单抗致SJS/TEN的风险以高龄、男性、肺癌、联合化疗者更高，黏膜损伤、异常皮疹等可能是SJS/TEN发生的早期信号；临床使用时可通过识别高危人群、密切监测首次用药至第5周期内的皮肤症状、加强患者教育等手段进行药学监护；出现相关症状时，应及时停药并进行对症治疗，以保障患者的用药安全。

Abstract

OBJECTIVE

To analyze the clinical characteristics of Stevens-Johnson syndrome （SJS） and toxic epidermal necrolysis （TEN） induced by tislelizumab， providing evidence for clinical medication safety.

METHODS

Case reports of tislelizumab-related SJS/TEN were retrieved from CNKI， VIP， Wanfang Data， PubMed， ScienceDirect， and Embase. Descriptive analysis was performed.

RESULTS

Seventeen cases from 17 publications were included （SJS 4 cases， TEN 13 cases）. Among them， there were 10 males and 7 females. Twelve patients were aged between 70 and 79 years. The predominant tumor type was lung cancer （10 cases）. Thirteen patients received combination therapy with chemotherapeutic drugs. The median onset time of SJS/TEN was 26 （4， 104） days. Nine patients developed SJS/TEN after the first administration of the drug. Sixteen patients exhibited prodromal rash symptoms， primarily characterized by severe skin damage such as skin detachment， accompanied by mucosal injury. Sixteen patients improved after symptomatic treatment， while one patient died.

CONCLUSIONS

Tislelizumab-associated SJS/TEN risk is higher in elderly patients， males， those with lung cancer and those receiving combination chemotherapy. Mucosal lesions and atypical rashes may indicate the early onset of SJS/TEN. During clinical use， pharmaceutical care can be carried out through measures such as identifying high-risk populations， closely monitoring skin symptoms from the first administration to the fifth treatment cycle， and enhancing patient education. When relevant symptoms occur， the medication should be promptly discontinued and symptomatic treatment should be administered to ensure the patient’s medication safety.

关键词

Keywords

references

崔萌纳，梁瑜，李文静，等 . 替雷利珠单抗致免疫相关性中毒性表皮坏死松解症1例 [J ] . 中国医院药学杂志， 2023 ， 43 （ 13 ）： 1530 - 1532 .

中华医学会皮肤性病学会分会药物不良反应研究中心 . Stevens-Johnson综合征/中毒性表皮坏死松解症诊疗专家共识 [J ] . 中华皮肤科杂志， 2021 ， 54 （ 5 ）： 376 - 381 .

汪慧芳，李越然，汪琳 . 替雷利珠单抗致Stevens-Johnson综合征1例 [J ] . 牡丹江医学院学报， 2023 ， 44 （ 4 ）： 109 - 111 .

张曼西 . 替雷利珠单抗免疫相关性Stevens-Johnson综合征1例 [J ] . 临床医学进展， 2023 ， 13 （ 7 ）： 11633 - 11637 .

孙丽丹，嵇书霞，张丹，等 . 替雷利珠单抗致Stevens-Johnson综合征的病例分析及药学监护 [J ] . 解放军药学学报， 2022 ， 38 （ 3 ）： 252 - 254 .

姚雄宇，董秀哲，侯国军，等 . 替雷利珠单抗免疫相关性Stevens-Johnson综合征1例 [J ] . 中国医院药学杂志， 2023 ， 43 （ 2 ）： 237 - 238 .

ZHOU Y S ， XUE H H ， LU C H ， et al . Treatment of tislelizumab-induced toxic epidermal necrolysis and agranulocytosis：a case report and literature review [J ] . Curr Drug Saf ， 2025 ， 20 （ 3 ）： 361 - 365 .

丁俊丽，徐乐臻，赵静宇，等 . 替雷利珠单抗致中毒性表皮坏死松解症1例报告 [J ] . 海军军医大学学报， 2023 ， 44 （ 12 ）： 1498 - 1500 .

程明霞，陈叶珊，赵迎超，等 . 替雷利珠单抗致中毒性表皮坏死松解型药疹1例 [J ] . 医药导报， 2022 ， 41 （ 4 ）： 581 - 583 .

WU S L ， XU C Y ， LIU H F . Case report：toxic epidermal necrolysis induced by tislelizumab in a patient with esophageal squamous cell carcinoma [J ] . Front Med（Lau-sanne）， 2024 ， 11 ： 1522525 .

郭虹霞，常慧玲，冯慧晶 . 免疫相关中毒性表皮坏死松解症1例及文献复习 [J ] . 中国肿瘤生物治疗杂志， 2022 ， 29 （ 11 ）： 1006 - 1009 .

王玉凤，王妮，白丽敏，等 . 经免疫检查点抑制剂治疗晚期胆囊癌后致中毒性表皮坏死松解症的病例分析 [J ] . 甘肃医药， 2021 ， 40 （ 10 ）： 947 - 950 .

邓爱清，殷晓芹，朱秋燕，等 . 替雷利珠单抗相关中毒性表皮坏死松解症1例 [J ] . 中国医院药学杂志， 2021 ， 41 （ 19 ）： 2039 - 2040 .

李杨，卢少欢，冯紫薇，等 . 临床药师参与1例替雷利珠单抗致中毒性表皮坏死松解症治疗实践 [J ] . 中国药业， 2024 ， 33 （ 6 ）： 121 - 124 .

丛慧颖，崔宏伟，于天为，等 . 血浆置换治疗免疫检查点抑制剂相关中毒性表皮坏死松解症2例 [J ] . 中国肿瘤生物治疗杂志， 2024 ， 31 （ 2 ）： 201 - 206 .

YANG X Q ， XU S M . Tislelizumab-induced toxic epidermal necrolysis-like cutaneous adverse reaction：rare complication of immune checkpoint inhibitor therapy [J ] . Am J Ther ， 2024 ， 31 （ 4 ）： e470 - e474 .

WU W J ， DA M H ， CHEN M ， et al . Toxic epidermal necrolysis post apalutamide with preceding tislelizumab administration in a patient with two cancers [J ] . J Dtsch Dermatol Ges ， 2023 ， 21 （ 10 ）： 1221 - 1223 .

苏逸，王青青，王萌冉，等 . 免疫检查点抑制剂相关中毒性表皮坏死松解症1例 [J ] . 中国临床实用医学， 2022 ， 13 （ 2 ）： 77 - 78 .

CHEN C ， WU B ， ZHANG C Y ， et al . Immune-related adverse events associated with immune checkpoint inhibitors：an updated comprehensive disproportionality analysis of the FDA adverse event reporting system [J ] . Int Immunopharmacol ， 2021 ， 95 ： 107498 .

SAMANI A ， ZHANG S ， SPIERS L ， et al . Impact of age on the toxicity of immune checkpoint inhibition [J ] . J Immunother Cancer ， 2020 ， 8 （ 2 ）： e000871 .

RAMOS-CASALS M ， BRAHMER J R ， CALLAHAN M K ， et al . Immune-related adverse events of checkpoint inhibitors [J ] . Nat Rev Dis Primers ， 2020 ， 6 （ 1 ）： 38 .

WEBER J S ， STEPHEN HODI F ， WOLCHOK J D ， et al . Safety profile of nivolumab monotherapy：a pooled analysis of patients with advanced melanoma [J ] . J Clin Oncol ， 2017 ， 35 （ 7 ）： 785 - 792 .

斯晓燕，何春霞，张丽，等 . 免疫检查点抑制剂相关皮肤不良反应诊治建议 [J ] . 中国肺癌杂志， 2019 ， 22 （ 10 ）： 639 - 644 .

董美岑 . PD-1单抗治疗肺恶性肿瘤的疗效及安全性分析 [D ] . 沈阳：中国医科大学， 2020 .

KATSUMOTO T R ， WILSON K L ， GIRI V K ， et al . Plasma exchange for severe immune-related adverse events from checkpoint inhibitors：an early window of opportunity? [J ] . Immunother Adv ， 2022 ， 2 （ 1 ）： ltac012 .

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