Case Report: Cadonilimab-related toxic epidermal necrolysis-like reactions successfully treated with supplemental Adalimumab

Front Immunol. 2023 Aug 3:14:1188523. doi: 10.3389/fimmu.2023.1188523. eCollection 2023.

Abstract

Cadonilimab is the first bi-specific antibody approved for certain malignancies in June 2022, which has a modified Fc structure to reduce immune-related adverse events. To date, no reports have described Cadonilimab-related toxic epidermal necrolysis (TEN). Here, we report the first case of TEN-like reactions occurring during the treatment of hepatocellular carcinoma with Cadonilimab in combination with Lenvatinib and transarterial chemoembolization, successfully treated with supplemental Adalimumab. We confirmed Cadonilimab as the culprit and observed significant improvement in the patient's condition following Adalimumab treatment. The case emphasizes the potential risk of Cadonilimab inducing TEN, and suggests that supplemental Adalimumab could be a favorable option for treating refractory Cadonilimab-related TEN.

Keywords: Adalimumab; Cadonilimab/AK104; case report; immune checkpoint inhibitor; immune-related adverse events; toxic epidermal necrolysis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adalimumab* / therapeutic use
  • Antibodies, Bispecific* / adverse effects
  • Antibodies, Bispecific* / therapeutic use
  • Carcinoma, Hepatocellular* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors* / adverse effects
  • Immune Checkpoint Inhibitors* / therapeutic use
  • Liver Neoplasms* / drug therapy
  • Male
  • Middle Aged
  • Stevens-Johnson Syndrome* / drug therapy
  • Stevens-Johnson Syndrome* / etiology
  • Treatment Outcome
  • Withholding Treatment

Substances

  • Adalimumab
  • Antibodies, Bispecific
  • Immune Checkpoint Inhibitors

Grants and funding

S-QC is supported by National Key R&D Program of China (Grant No. 2022YFC2705300).