Case Report and Literature Review on Skin Toxicity Induced by PD-1 Inhibitor in a Penile Cancer with Massive Ulceration of Chemoradiotherapy-Resistant and Successful Treatment by Immunotherapy

病例报告及文献综述:PD-1抑制剂在化疗放疗耐药且伴有巨大溃疡的阴茎癌患者中诱发的皮肤毒性,以及免疫疗法成功治疗的案例

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Abstract

Penile cancer is a rare malignant tumor with a poor prognosis in advanced stages. Immune checkpoint inhibitors (ICIs) have demonstrated promising efficacy in patients with advanced penile cancer, but it can also induce immune-related adverse events (irAEs). This article reports a patient who achieved almost a complete response to the PD-1 inhibitor sintilimab as third-line treatment for advanced penile squamous cell cancer with massive ulceration of chemoradiotherapy-resistant, and successful treatment by immunotherapy. One year into maintenance therapy with sintilimab, skin toxicity in the form or grade-2 skin rashes and grade-3 pruritus occurred. Sintilimab was permanently discontinued. The skin toxicity was effectively controlled by oral prednisone at a daily dosage of 15 mg. At the last follow-up of 16 months after sintilimab discontinuation, the patient remained in partial response, with total progression-free survival exceeding 30 months. We also conducted a comprehensive literature search, and summarized skin toxicity of ICIs administration. These articles suggested that immune-related skin toxicity may be indicative of good treatment response.

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