Rapid reduction of immune checkpoint inhibitor–associated pruritus with nemolizumab

Pruritus is a prevalent and clinically significant adverse event of immune checkpoint inhibitors, often resulting in significant impairment of quality of life and potential interruption of oncologic therapy.Interleukin-31 (IL-31) is a key mediator of neuroimmune itch signalling and has been shown to be elevated in patients with pruritic cutaneous irAEs.We report the case of an 80-year-old male patient with severe, chronic, therapy-refractory ICIassociated pruritus without primary inflammatory skin lesions, who demonstrated a rapid and complete response to IL-31 receptor blockade with nemolizumab.Pruritus resolved within 48 hours after the first injection, with sustained remission and marked improvement in quality of life.