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Peer-reviewedCC BYRespirology case reports

Probable Stevens–Johnson Syndrome During Taletrectinib Treatment After Crizotinib‐Related Rash in ROS1‐Positive Lung Cancer

  • Hirotoshi Yasui1
  • Ryo Fukaura2
  • Miyu Misaki2
  • Souma Usui1
  • Saho Katsumata1
  • Ryo Niimi1
  • Ko Ohara1
  • Kaito Sano1
  • Yasutaka Mori1
  • Tomofumi Shibata1
  • Yasutaka Fukui1
  • Mitsuru Odate1
1 more authors
  • Yasushi Makino1
  1. 1Department of Respiratory Medicine Toyohashi Municipal Hospital Toyohashi Aichi Japan.
  2. 2Department of Dermatology Toyohashi Municipal Hospital Toyohashi Aichi Japan.
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Abstract

Severe cutaneous adverse reactions to taletrectinib, a next-generation ROS1 inhibitor for ROS1-rearranged non-small cell lung cancer, remain poorly described. A 52-year-old woman with ROS1-rearranged lung adenocarcinoma developed a Grade 3 rash during crizotinib therapy. After improvement, taletrectinib was initiated. On Day 21, conjunctival hyperaemia appeared, followed by high fever, neutropenia, widespread trunk-dominant erythema, and lower-lip mucosal involvement. Although epidermal detachment, a positive Nikolsky sign, and characteristic epidermal necrosis were absent, and typical target lesions were not documented during the acute phase, the clinical course was considered consistent with probable Stevens-Johnson syndrome. Fever and ocular symptoms rapidly improved after taletrectinib discontinuation and systemic corticosteroid therapy. Infection and human herpesvirus 6 (HHV-6) reactivation were not identified, and ALDEN and Naranjo assessments supported a probable association with taletrectinib. During ROS1-TKI therapy, fever and neutropenia should prompt consideration of severe cutaneous adverse reactions as well as infection.

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Cite

BibTeXRIS
BibTeX
@article{yasui2026probable,
  title = {{Probable Stevens–Johnson Syndrome During Taletrectinib Treatment After Crizotinib‐Related Rash in ROS1‐Positive Lung Cancer}},
  author = {Hirotoshi Yasui and Ryo Fukaura and Miyu Misaki and Souma Usui and Saho Katsumata and Ryo Niimi and Ko Ohara and Kaito Sano and Yasutaka Mori and Tomofumi Shibata and Yasutaka Fukui and Mitsuru Odate and Yasushi Makino},
  journal = {Respirology case reports},
  year = {2026},
  month = oct,
  doi = {10.1002/rcr2.70782},
  url = {https://europepmc.org/article/PMC/PMC13717595},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Probable Stevens–Johnson Syndrome During Taletrectinib Treatment After Crizotinib‐Related Rash in ROS1‐Positive Lung Cancer
AU  - Hirotoshi Yasui
AU  - Ryo Fukaura
AU  - Miyu Misaki
AU  - Souma Usui
AU  - Saho Katsumata
AU  - Ryo Niimi
AU  - Ko Ohara
AU  - Kaito Sano
AU  - Yasutaka Mori
AU  - Tomofumi Shibata
AU  - Yasutaka Fukui
AU  - Mitsuru Odate
AU  - Yasushi Makino
PY  - 2026
DA  - 2026/10/29
JO  - Respirology case reports
DO  - 10.1002/rcr2.70782
UR  - https://europepmc.org/article/PMC/PMC13717595
AB  - Severe cutaneous adverse reactions to taletrectinib, a next-generation ROS1 inhibitor for ROS1-rearranged non-small cell lung cancer, remain poorly described. A 52-year-old woman with ROS1-rearranged lung adenocarcinoma developed a Grade 3 rash during crizotinib therapy. After improvement, taletrectinib was initiated. On Day 21, conjunctival hyperaemia appeared, followed by high fever, neutropenia, widespread trunk-dominant erythema, and lower-lip mucosal involvement. Although epidermal detachment, a positive Nikolsky sign, and characteristic epidermal necrosis were absent, and typical target lesions were not documented during the acute phase, the clinical course was considered consistent with probable Stevens-Johnson syndrome. Fever and ocular symptoms rapidly improved after taletrectinib discontinuation and systemic corticosteroid therapy. Infection and human herpesvirus 6 (HHV-6) reactivation were not identified, and ALDEN and Naranjo assessments supported a probable association with taletrectinib. During ROS1-TKI therapy, fever and neutropenia should prompt consideration of severe cutaneous adverse reactions as well as infection.
SN  - 2051-3380
ER  -