{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:13:00Z","timestamp":1787008380542,"version":"build-2736575974"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T00:00:00Z","timestamp":1729296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>There is currently limited data on cross-sensitivity between immunotherapy agents. In this case study, we report a case of severe anaphylaxis to both pembrolizumab and cemiplimab.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Pembrolizumab (Keytruda) and cemiplimab (Libtayo) are both approved for the treatment of metastatic cutaneous squamous cell carcinoma. Infusion reactions occur rarely with immunotherapy agents. However, if infusion reactions are severe, the treatment should be discontinued, and there is no guidance as to whether another immunotherapy agent may be used. An 87-year-old-male was diagnosed with metastatic cutaneous squamous cell carcinoma expressing a PD-L1 combined positive score of 81%-90%. He was treated with pembrolizumab and, 15 minutes after completion of the first infusion, developed swelling of the eyelids, ears, and tongue in addition to a whole-body rash without pruritus. Due to the severity of the reaction, pembrolizumab was permanently discontinued and the patient was then started on cemiplimab. The patient received a high-dose corticosteroid as premedication before the first infusion of cemiplimab and tolerated the treatment without any adverse effects. However, when the corticosteroid premedication dose was decreased before the second cycle, the patient had a severe infusion reaction to cemiplimab requiring discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A patient with metastatic cutaneous squamous cell carcinoma developed a severe hypersensitivity reaction to pembrolizumab and subsequently to cemiplimab, despite premedication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajhp\/zxae286","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T15:22:20Z","timestamp":1729178540000},"page":"e252-e255","source":"Crossref","is-referenced-by-count":2,"title":["Severe hypersensitivity reactions to 2 immunotherapy agents in a patient with cutaneous squamous cell carcinoma"],"prefix":"10.1093","volume":"82","author":[{"given":"Justin C","family":"Liauw","sequence":"first","affiliation":[{"name":"Rhode Island Hospital\/Brown University Health Cancer Institute , Providence, RI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Silveira","sequence":"additional","affiliation":[{"name":"Rhode Island Hospital , Providence, RI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iole","family":"Ribizzi-Akthar","sequence":"additional","affiliation":[{"name":"Brown University Health Cancer Institute , Providence, RI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,19]]},"reference":[{"key":"2025022017452130600_CIT0001","doi-asserted-by":"crossref","first-page":"733917","DOI":"10.3389\/fonc.2021.733917","article-title":"Immunotherapy for the treatment of cutaneous squamous cell carcinoma","volume":"11","author":"Boutros","year":"2021","journal-title":"Front Oncol"},{"key":"2025022017452130600_CIT0002","doi-asserted-by":"crossref","first-page":"3653","DOI":"10.3390\/cancers14153653","article-title":"Advances in cutaneous squamous cell carcinoma management","volume":"14","author":"Burns","year":"2022","journal-title":"Cancers (Basel)"},{"key":"2025022017452130600_CIT0003","volume-title":"Prescribing information","author":"Libtayo","year":"2023"},{"key":"2025022017452130600_CIT0004","volume-title":"Prescribing information","author":"Keytruda","year":"2023"},{"key":"2025022017452130600_CIT0005","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s00280-020-04161-6","article-title":"Dose exploration results from phase 1 study of cemiplimab, a human monoclonal programmed death (PD)-1 antibody, in Japanese patients with advanced malignancies","volume":"87","author":"Kitano","year":"2021","journal-title":"Cancer Chemother Pharmacol"},{"key":"2025022017452130600_CIT0006","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1002\/psp4.12139","article-title":"Model-based characterization of the pharmacokinetics of pembrolizumab: a humanized anti\u2013PD-1 monoclonal antibody in advanced solid tumors","volume":"6","author":"Ahamadi","year":"2017","journal-title":"CPT Pharmacometrics Syst Pharmacol"},{"issue":"2","key":"2025022017452130600_CIT0007","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.iac.2021.12.006","article-title":"Hypersensitivity reactions and immune-related adverse events to immune checkpoint inhibitors: approaches, mechanisms, and models","volume":"42","author":"Park","year":"2022","journal-title":"Immunol Allergy Clin N Am"},{"issue":"3","key":"2025022017452130600_CIT0008","doi-asserted-by":"crossref","first-page":"949","DOI":"10.3892\/etm.2021.10381","article-title":"Hypersensitivity reactions to monoclonal antibodies: classification and treatment approach (review)","volume":"22","author":"Pintea","year":"2021","journal-title":"Exp Ther Med"},{"issue":"3","key":"2025022017452130600_CIT0009","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1159\/000526561","article-title":"A case of nonsmall-cell lung cancer with anaphylaxis after 41 courses of pembrolizumab along with adrenal insufficiency as an immune-related adverse event","volume":"15","author":"Nakamura","year":"2022","journal-title":"Case Rep Oncol"},{"issue":"5","key":"2025022017452130600_CIT0010","doi-asserted-by":"crossref","first-page":"251","DOI":"10.21037\/atm-21-7006","article-title":"Immune checkpoint inhibitors and adrenal insufficiency: a large sample case series study","volume":"10","author":"Cui","year":"2022","journal-title":"Ann Transl Med"},{"key":"2025022017452130600_CIT0011","volume-title":"Prescribing information","author":"Opdivo","year":"2024"},{"issue":"6","key":"2025022017452130600_CIT0012","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1007\/s12325-018-0707-z","article-title":"Safety of polysorbate 80 in the oncology setting","volume":"35","author":"Schwartzberg","year":"2018","journal-title":"Adv Ther"},{"issue":"3","key":"2025022017452130600_CIT0013","doi-asserted-by":"crossref","first-page":"297","DOI":"10.2217\/fon-2018-0662","article-title":"Hypersensitivity and infusion-site adverse events with intravenous fosaprepitant after anthracycline-containing chemotherapy: a retrospective study","volume":"15","author":"Boccia","year":"2019","journal-title":"Future Oncol"},{"key":"2025022017452130600_CIT0014","volume-title":"Prescribing information","author":"Emend","year":"2022"},{"key":"2025022017452130600_CIT0015","volume-title":"Prescribing information","author":"Docetaxel injection","year":"2021"},{"issue":"2","key":"2025022017452130600_CIT0016","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.tox.2004.12.016","article-title":"Cross-reactivity among drugs: clinical problems","volume":"209","author":"Romano","year":"2005","journal-title":"Toxicology"},{"key":"2025022017452130600_CIT0017","first-page":"129","article-title":"Hypersensitivity reactions during treatment with biological agents","volume":"34","author":"Puxedu","year":"2016","journal-title":"Clin Exp Rheumatol"},{"issue":"2","key":"2025022017452130600_CIT0018","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1053\/j.seminoncol.2017.06.002","article-title":"A molecular and preclinical comparison of the PD-1- targeted T-cell checkpoint inhibitors nivolumab and pembrolizumab","volume":"44","author":"Fessas","year":"2017","journal-title":"Semin Oncol"},{"issue":"21","key":"2025022017452130600_CIT0019","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1093\/ajhp\/zxz189","article-title":"Treatment with pembrolizumab after hypersensitivity reaction to nivolumab in a patient with hepatocellular carcinoma","volume":"76","author":"Choi","year":"2019","journal-title":"Am J Health-Syst Pharm"},{"issue":"7","key":"2025022017452130600_CIT0020","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1200\/JCO.2015.66.1389","article-title":"Safety profile of nivolumab monotherapy: a pooled analysis of patients with advanced melanoma","volume":"35","author":"Weber","year":"2017","journal-title":"J Clin Oncol"},{"key":"2025022017452130600_CIT0021","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.ejca.2020.09.032","article-title":"How to manage patients with corticosteroids in oncology in the era of immunotherapy","volume":"141","author":"Aldea","year":"2020","journal-title":"Eur J Cancer"}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxae286\/60123025\/zxae286.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/82\/5\/e252\/60123025\/zxae286.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/82\/5\/e252\/60123025\/zxae286.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T12:45:34Z","timestamp":1740055534000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/article\/82\/5\/e252\/7828180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,19]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,10,19]]},"published-print":{"date-parts":[[2025,2,20]]}},"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxae286","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,3,1]]},"published":{"date-parts":[[2024,10,19]]}}}