Severe skin reaction after immunotherapy for metastatic gastric cancer

This gastric cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Subtype
Adenocarcinoma
Biomarkers
pMMR; PD-L1 CPS ~10; HER2 1+
Sex
Male
Spread to
liver
Treatment
immunotherapy
Outcome
Living With Cancer

Treatment course, step by step

  1. Chemotherapy plus sintilimab was recommended, but chemotherapy was declined.
  2. He received one dose of sintilimab.
  3. Sintilimab was permanently stopped after he developed a severe skin reaction.

What happened, in summary

A 60-year-old man had metastatic gastric adenocarcinoma with multiple liver metastases. Testing showed proficient mismatch repair, PD-L1 CPS around 10, and HER2 1+ expression. Chemotherapy plus the immunotherapy sintilimab was recommended, but his family declined chemotherapy.

He received a first dose of sintilimab in August 2024. Seven days later, he developed fever and a rapidly worsening widespread rash. The reaction progressed to toxic epidermal necrolysis, with severe blistering and skin loss affecting most of his body. Sintilimab was permanently stopped.

He required intensive supportive treatment, including fluids, immune treatment for the skin reaction, wound care, nutritional support, and antibiotics for an associated wound infection. His skin gradually began to heal, and gastrointestinal bleeding also stabilized.

By day 25, nearly all of the skin wounds had healed. He was discharged after 32 days with stable vital signs and no active bleeding. Follow-up found no recurrence of the severe skin reaction or secondary infection.

Where this story comes from

This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full

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