Nivolumab-induced Stevens-Johnson syndrome: Not only due to PD-1 inhibition

Immune checkpoint inhibitors (ICIs) have entailed a radical change in the therapeutic landscape of multiple tumors. The ICIs enhance immunogenic activity against tumor cells through suppression of negative signaling over cytotoxic T cells. Nivolumab is a fully human immunoglobulin G4 antibody that blocks the interaction between programmed cell death protein-1 (PD-1) and its corresponding ligand. Interfering with physiological mechanisms of peripheral immune tolerance conducts intensified systemic immune response, which enhances antitumor activity, but also favors inflammation leading to a wide spectrum of immune-related adverse effects (irAEs).