Pregabalin for Severe Immunotherapy Induced Pruritus: A Case Report

Document Type

Conference Proceeding

Publication Date

6-2026

Publication Title

Journal of Pain and Symptom Management

Abstract

Immune-related cutaneous adverse events represent a significant clinical problem in cancer checkpoint inhibitor therapy, the most rapidly growing cancer treatment (1). Pruritus affects approximately 14% to 47% of patients undergoing treatment with immune checkpoint inhibitors, with 1% to 3% experiencing severe, widespread, and debilitating symptoms (2). This adverse effect significantly impacts quality of life yet remains poorly understood and often difficult to manage.

Standard treatments such as topical agents and antihistamines offer limited relief, especially in cases of generalized pruritus. Systemic corticosteroids may provide transient benefit but are generally avoided for long-term use due to adverse effects.

We report the case of a 60-year-old female with metastatic non-small cell lung carcinoma treated with carboplatin, pemetrexed, and pembrolizumab. She Initially developed itchy rash which somewhat responded to courses of prednisone. Then she developed generalized pruritus without rash. Multiple courses of prednisone, as well as trials of hydroxyzine, topical agents, and topical lidocaine, yielded minimal and temporary relief.

Given the refractory nature of her symptoms, she was started on pregabalin (Lyrica). According to literature (3) Pregabalin may exert antipruritic effects by inhibiting the α2δ subunit of voltage-gated calcium channels and suppressing the release of excitatory neurotransmitters such as substance P and calcitonin gene-related peptide. Following initiation of 50mg pregabalin at nighttime, the patient experienced significant improvement in pruritus. This case highlights the potential role of pregabalin as an effective therapeutic option for severe, immunotherapy-induced pruritus, particularly when standard treatments fail.

Volume

71

Issue

6

First Page

e1159

Last Page

e1160

Comments

Annual Assembly of Hospice and Palliative Care, March 4-7, 2026, San Diego, CA

DOI

10.1016/j.jpainsymman.2026.04.496

ISSN

1873-6513

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