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      Synergistic Toxicities from Multiple Therapies for Synchronous Malignancies

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          Abstract

          Patients may present with multiple malignancies in the setting of particular environmental and occupational exposures. These patients often require combination systemic therapy, which has not yet been studied for concurrent use. While toxicities for specific chemotherapies and immunotherapies may be well known, the possibility of exaggerated toxicity due to combination therapy exists and is understudied. Several trials are underway that may shed further light on how combination therapies affect patient toxicity. This case report outlines the unfortunate development of severe edema and rash, refractory to traditional methods of management, from combining immunotherapy and chemotherapy.

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          Most cited references7

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          Pembrolizumab plus Chemotherapy in Metastatic Non–Small-Cell Lung Cancer

          First-line therapy for advanced non-small-cell lung cancer (NSCLC) that lacks targetable mutations is platinum-based chemotherapy. Among patients with a tumor proportion score for programmed death ligand 1 (PD-L1) of 50% or greater, pembrolizumab has replaced cytotoxic chemotherapy as the first-line treatment of choice. The addition of pembrolizumab to chemotherapy resulted in significantly higher rates of response and longer progression-free survival than chemotherapy alone in a phase 2 trial.
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            Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial.

            Atezolizumab is a humanised antiprogrammed death-ligand 1 (PD-L1) monoclonal antibody that inhibits PD-L1 and programmed death-1 (PD-1) and PD-L1 and B7-1 interactions, reinvigorating anticancer immunity. We assessed its efficacy and safety versus docetaxel in previously treated patients with non-small-cell lung cancer.
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              Pembrolizumab plus Chemotherapy for Squamous Non–Small-Cell Lung Cancer

              Standard first-line therapy for metastatic, squamous non-small-cell lung cancer (NSCLC) is platinum-based chemotherapy or pembrolizumab (for patients with programmed death ligand 1 [PD-L1] expression on ≥50% of tumor cells). More recently, pembrolizumab plus chemotherapy was shown to significantly prolong overall survival among patients with nonsquamous NSCLC.
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                Author and article information

                Journal
                Case Rep Oncol
                Case Rep Oncol
                CRO
                CRO
                Case Reports in Oncology
                S. Karger AG (Basel, Switzerland )
                1662-6575
                6 February 2023
                Jan-Dec 2023
                6 February 2023
                : 16
                : 1
                : 45-48
                Affiliations
                [a ]Division of Oncology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
                [b ]Clinical Hematology-Oncology Pharmacist, George E. Wahlen Veterans Affairs Hospital, Salt Lake City, UT, USA
                [c ]Division of General Internal Medicine, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
                Author notes
                Correspondence to: Shiven B. Patel, shiven.patel@ 123456hci.utah.edu
                Article
                529017
                10.1159/000529017
                9903141
                36761367
                6833a207-6123-4adb-956b-eec212a7d679
                © 2023 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) ( http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.

                History
                : 25 October 2022
                : 3 January 2023
                : 2023
                Page count
                References: 8, Pages: 4
                Funding
                The submission and publishing of this case report is not sponsored, and the authors have no funding sources to declare.
                Categories
                Case Report

                Oncology & Radiotherapy
                docetaxel,atezolizumab,edema,non-small cell lung cancer,prostate cancer
                Oncology & Radiotherapy
                docetaxel, atezolizumab, edema, non-small cell lung cancer, prostate cancer

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