{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:22:21Z","timestamp":1788326541372,"version":"build-2803163510"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pembrolizumab-induced immune-related oral mucositis (irOM) is a rare and often underrecognized toxicity. This study aimed to systematically characterize its clinical profile, histopathologic patterns, management strategies, and outcomes to support timely diagnosis and evidence-based care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search of PubMed, EMBASE, Web of Science, WanFang Data, and CNKI was performed using a combination of MeSH terms (e.g., \u201cPembrolizumab,\u201d \u201cOral Mucositis,\u201d \u201cStomatitis,\u201d \u201cMucous Membrane Pemphigoid,\u201d and \u201cImmune-Related Adverse Events\u201d) and free-text terms (e.g., \u201canti-PD-1\u201d and \u201ccheckpoint inhibitor toxicity\u201d), with Boolean operators (AND\/OR) applied to maximize retrieval; reports published up to July 31, 2025, were included. The quality of case reports was evaluated using the JBI Critical Appraisal Checklist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 18 patients, the median age was 72 years (range 15, 88) and 72.2% were male. The median onset of irOM was 24 weeks (range 3, 66), consistent with a delayed presentation. Clinically, painful oral ulcers or erosions were most frequently observed (50.0%), followed by dysphagia or odynophagia (27.8%). Histopathologic evaluation most often revealed a pemphigoid-like pattern (27.8%) or mixed inflammatory infiltrates (22.2%), with additional findings including ulceration with granulation tissue, lichenoid mucositis, plasma cell infiltrates, and epithelial hyperplasia. Systemic corticosteroids were the mainstay of therapy (88.9%), while pembrolizumab was discontinued in one-third of cases (33.3%). Refractory disease occasionally required immunomodulatory agents such as methotrexate (16.7%) or infliximab (11.1%). Clinical outcomes were generally favorable, with 88.9% of patients achieving symptomatic improvement or remission and a median recovery time of 6 weeks (range 2, 52). On rechallenge, 3 of 4 patients had no recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pembrolizumab-induced irOM usually develops after months of treatment, presenting as ulcerative mucositis, sometimes extending to the airway or esophagus. Biopsy may show pemphigoid-like changes. Corticosteroids are effective, and immunosuppressants can be used for refractory cases. Recovery is typically within weeks and rechallenge is feasible for select patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1710588","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T06:45:13Z","timestamp":1769582713000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical characteristics, management, and prognosis of pembrolizumab-induced immune-related oral 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