Case Report: Rapid TEN Progression After PD-1 Inhibitor Switch

A 69-year-old male with recurrent hypopharyngeal cancer experienced a Grade 1 rash during tislelizumab therapy. Within 2 days after switching to pembrolizumab, his condition deteriorated into toxic epidermal necrolysis involving over 95% of body surface area. The report, authored by Meiling Huang and published on figshare in May 2026, includes pathological findings suggesting alterations in the cutaneous immune microenvironment.

Use Cases

• Study the temporal progression of severe cutaneous adverse reactions based on the detailed timeline of drug switch and symptom onset.
• Analyze pathological correlates of toxic epidermal necrolysis based on the described skin biopsy findings of epidermal necrosis and T lymphocyte infiltration.
• Investigate potential mechanisms of fulminant progression based on the reported immunohistochemistry results showing PD-L1 expression but negative PD-1 expression.
• Compare adverse event profiles between different PD-1 inhibitors based on the described clinical response to tislelizumab versus pembrolizumab.

Strengths

• Provides a detailed clinical timeline, including the specific 2-day window for rapid deterioration after drug switch.
• Includes concrete pathological findings, such as epidermal necrosis and infiltration of CD4 and CD8 positive T lymphocytes.
• Contains quantified clinical detail, specifically the involvement of over 95% of body surface area.

Limitations

• Dataset is a single case report (39.4 KB PDF), offering limited statistical power for generalization.
• Row count and column-level documentation are absent; data structure must be inferred from the narrative.
• Data may reflect bias inherent to a single clinical observation rather than a population study.

Provenance

Source

figshare

Collection Method

Clinical case documentation.

Freshness

Last updated 2026-05-18 05:30:35.