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Table 2 Timeline of progression of acral necrosis since administration of PD-1 inhibitor

From: Acral vascular necrosis associated with immune-check point inhibitors: case report with literature review

Timeline from Treatment Clinical Progression
Day 0 1st dose of pembrolizumab (No symptoms)
At 25 weeks Raynaud’s like symptoms (Patient started on nifedipine)
At 27 weeks No resolution of Raynaud’s symptoms and persistence of cyanosis (Patient started on prednisone)
At 29 weeks Development of dry gangrene at fingertips bilaterally
At 33 weeks Extension of necrosis and development of ulceration. Patient still on pembrolizumab. Sympathectomy performed (patient still on nifedipine and glucocorticoids)
At 37 weeks Tumor progression (pembrolizumab stopped). Extension of the necrosis stopped after week 37