ArticleCase reports in oncology
Integrated Traditional Chinese and Western Medicine for Severe Tislelizumab-Induced Rash: A Case Report.
Article in Case reports in oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Programmed death receptor 1 inhibitors are widely used tumor immunotherapy agents, yet they frequently trigger immune-related adverse events (irAEs), among which severe cutaneous toxicities are life-threatening and often interrupt anti-tumor treatment. Conventional Western medicine relying on glucocorticoids carries notable side effects, while integrated traditional Chinese medicine and Western medicine (TCM-WM) offers a promising alternative therapeutic strategy. This work aims to explore the clinical efficacy and safety of combined TCM-WM intervention for severe tislelizumab-induced cutaneous irAEs, elaborate traditional Chinese medicine (TCM) syndrome differentiation logic, and accumulate clinical evidence for managing such severe skin adverse reactions. Case Presentation: A 71-year-old male patient with right lung squamous cell carcinoma complicated by supraclavicular lymph node metastasis developed grade 3 severe cutaneous irAE after tislelizumab immunotherapy, diagnosed with TCM syndrome of intermingled damp-heat, stasis, and toxin. Comprehensive Western medicine treatment (glucocorticoids, antihistamines, topical anti-inflammatory ointments, and analgesics) combined with individualized oral modified TCM granules, external herbal washing, and characteristic TCM therapies was implemented. After 12 days of inpatient treatment and 3 months of continuous follow-up, the patient's severe rash, skin pain, and pruritus were fully resolved without recurrence. The duration of intravenous glucocorticoid administration was shortened to only 7 days followed by oral tapering, and no significant adverse reactions occurred during the whole treatment course. Conclusion: Integrated TCM-WM demonstrates synergistic efficacy in the treatment of severe tislelizumab-induced cutaneous irAEs by regulating immune balance and eliminating pathogenic factors. It provides a valuable therapeutic option for such patients and warrants further validation in larger sample studies.
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