1.Pharmaceutical care for a case of severe dermal toxicity induced by durvalumab
Liulian JI ; Zhengbi QIN ; Pengcheng LIU ; Xiaowen DENG ; Lili LIU ; Lijuan YAO ; Tingting LIU ; Pingchen GU
China Pharmacy 2026;37(1):88-91
OBJECTIVE To provide references for the accurate identification and management of immune-related cutaneous adverse events (irCAEs) caused by durvalumab, and ensuring safe clinical drug use. METHODS Clinical pharmacists participated in the diagnosis and treatment process of a patient with gallbladder cancer who developed irCAEs caused by durvalumab. The clinical pharmacists systematically reviewed the patient’s past medical history and medication history, and assisted physicians in assessing the association between adverse drug reactions and administered drugs. Meanwhile, the clinical pharmacists conducted a graded assessment of the adverse reaction, proposed recommendations such as discontinuing durvalumab and adjusting the administration regimen of glucocorticoids, assisted physicians in restarting immunotherapy, and carried out medication education and other pharmaceutical care. RESULTS The occurrence of irCAEs in this patient was “highly likely” related to durvalumab and was classified as severe. The physicians adopted the clinical pharmacist’s opinion, and after symptomatic treatment, the patient’s skin symptoms improved, and discharged with medication. After the completion of glucocorticoid therapy for the patient, the physician restarted immunotherapy with tislelizumab, and no related adverse reactions occurred again in the patient. CONCLUSIONS Durvalumab can cause irCAEs such as severe skin maculopapular rash. In clinical practice, it is crucial to promptly identify and discontinue suspicious drugs, immediately implement effective symptomatic treatment measures, and actively resume immunotherapy to ensure the continuity and safety of the patient’s treatment.
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