ArticleCancer management and research2026
Toxic Epidermal Necrolysis in a Patient with Hepatocellular Carcinoma Receiving Pembrolizumab Plus Regorafenib: A Case Report.
Article in Cancer management and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Immune checkpoint inhibitors (ICIs), particularly when combined with targeted therapies, have significantly improved outcomes in patients with advanced cancers; however, they are also associated with a broad spectrum of immune-related adverse events (irAEs). Among these, severe cutaneous adverse reactions (SCARs) such as Toxic Epidermal Necrolysis (TEN), though rare, pose considerable diagnostic and therapeutic challenges. This report details a case of TEN induced by the combination of pembrolizumab and regorafenib, with the aim of enhancing clinical awareness and management of this serious complication. Case Description: A 34-year-old woman diagnosed with hepatocellular carcinoma was treated with pembrolizumab every three weeks in combination with daily regorafenib. Approximately two months after initiating therapy, the patient developed generalized erythema, blistering, and subsequent epidermal detachment affecting >30% of her body surface area (BSA) with mucosal involvement, consistent with Toxic Epidermal Necrolysis (TEN). With a SCORTEN score of 4 indicating a high mortality risk, she was transferred to the Intensive Care Unit (ICU) due to the life-threatening nature of her condition. An initial misdiagnosis as a viral exanthem delayed appropriate management. The diagnosis was ultimately confirmed by clinical evaluation, drug causality assessment using ALDEN and Naranjo scales (Pembrolizumab: ALDEN 5, Naranjo 6; Regorafenib: ALDEN 5, Naranjo 5; both indicating "probable" causality for each drug), and exclusion of other potential causes. Treatment involved immediate discontinuation of both anticancer agents, high-dose intravenous methylprednisolone, intravenous immunoglobulin, and comprehensive supportive care. Marked clinical improvement was observed. Reintroduction of regorafenib as monotherapy did not result in recurrence, implicating pembrolizumab as the primary causative agent. Conclusion: This case affirms that early recognition, a systematic protocol involving high-dose corticosteroids/intravenous immunoglobulin, and multidisciplinary collaboration are vital for managing life-threatening cutaneous irAEs, while also highlighting that robust pharmacovigilance and patient education are fundamental to the safe implementation of ICI-based combination therapies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.