Deadly Skin Reactions Linked to Tevimbra, Similar Drugs in Case Study

Patient was able to make a full recovery from Tevimba-induced Stephens-Johnson Syndrome (SJS) after being treated with tumor necrosis factor-α medications and hemoperfusion.

New research warns that patients taking Tevimbra, and similar cancer immunotherapy drugs, face a higher risk of developing Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN).

A case study published by Chinese researchers in the journal Frontiers in Immunology late last month, found the side effects of Tevimbra led to serious skin reactions across more than 80% of a patient’s body.

Tevimbra (tislelizumab) is a programmed cell death-1 (PD-1) inhibitor approved to treat several types of cancer, including esophageal and gastric cancer. It works by blocking specific proteins that allow cancer cells to evade the immune system, similar to other immunotherapy drugs such as Opdivo, Keytruda and Libtayo. The medication received its first U.S. Food and Drug Administration approval in March 2024.

The patient’s symptoms were consistent with Stevens-Johnson Syndrome (SJS), a rare but life-threatening reaction linked to various medications. The condition causes the skin to burn from the inside out, leading to blistering, severe rashes, and, in extreme cases, separation of the skin from the body. When more than 30% of the body is affected, the disorder is classified as Toxic Epidermal Necrolysis (TEN).

Both SJS and TEN require intensive inpatient treatment, often in a hospital burn unit, and can result in permanent blindness, organ failure and other long-term complications.

Led by Hongtao Yu, the case study detailed an elderly male patient with liver cancer taking Tevimbra. The patient developed SJS/TEN over 80% of his body after receiving his first Tevimbra infusion.

Doctors attempted to treat the patient conventionally using corticosteroids combined with IV immunoglobulin, yet the treatment did not stop SJS/TEN from progressing. They then began treating the patient with a tumor necrosis factor-α (TNF-α) inhibitor and hemoperfusion.

The new treatment led to the patient’s eventual full recovery, which the doctors emphasized was cost-effective and well-tolerated.

“Conventional treatment with systemic corticosteroids combined with intravenous immunoglobulin was ineffective in halting disease progression. Subsequently, adjunctive therapy with a tumor necrosis factor-α (TNF-α) inhibitor and hemoperfusion was initiated, leading to the patient’s eventual recovery.”

— Hongtao Yu, Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Induced by Tislelizumab: A Case Report and Literature Review

Researchers emphasized the need for early intervention when patients develop SJS/TEN, warning that it is crucial for doctors to look for early warning signs and begin early treatment to reduce the risk of death. They indicated that this was the first reported case of using a TNF-α inhibitor to treat tislelizumab-induced SJS/TEN.

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