Clinicopathological characteristics and management of nivolumab/pembrolizumab‐induced fasciitis in cancer patients

Abstract This study provided a systematic analysis of the clinical manifestations of fasciitis caused by nivolumab and pembrolizumab. Its objective is to lay a scientific foundation for the early detection, precise diagnosis, and standardized handling of this adverse effect in clinical settings. Through an exhaustive search of multiple databases encompassing all relevant case reports up to June 25, 2025, we retrospectively analyzed the clinical characteristics of 47 patients who developed fasciitis due to the use of nivolumab and pembrolizumab. Among them, the average age of 42 patients was 63.5 years (25–82 years), and 24 out of 41 cases were male. In 42 case records, the median time from the initiation of these drugs to the onset of fasciitis was 11 months (1–36 months). Additionally, 22 case records showed that the median treatment cycle from the initiation of these drugs to the onset of fasciitis was 13 cycles (2–56 cycles). Diagnostic results showed that 39 cases (83.0%) were diagnosed as fasciitis and 8 cases (17%) as myofasciitis. Patients generally had a favorable prognosis after discontinuing nivolumab and pembrolizumab and receiving systemic steroid therapy. In conclusion, while fasciitis represents a rare complication of nivolumab and pembrolizumab treatment, it can be effectively controlled in most cases with early identification and prompt implementation of interventions such as drug discontinuation and treatment with steroids and other medications. These findings offer a scientific foundation for the early detection, accurate diagnosis, and standardized management of this condition in clinical practice.