Bilateral neuroretinitis and anterior uveitis following ipilimumab treatment for metastatic melanoma

Hahn, Laura; Pepple, Kathryn L.

doi:10.1186/s12348-016-0082-3

Cited by 48 publications

(17 citation statements)

References 18 publications

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“…Several clinicians have reported on cases with ocular side effects of ipilimumab, with the typical cases of immune-related ocular side effects appearing to be similar to Vogt-Koyanagi-Harada-like syndrome 2,3. However, our current case did not have findings suggestive of Vogt-Koyanagi-Harada-like syndrome, nor did it have any typical angiographic findings which suggested the presence of central serous chorioretinopathy (CSC).…”

Section: Discussionmentioning

confidence: 52%

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<p>A Case Of Ipilimumab-Induced Unusual Serous Retinal Detachment In Bilateral Eyes</p>

Miyakubo¹,

Mukai²,

Nakamura³

et al. 2019

IMCRJ

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PurposeIpilimumab is an immune checkpoint inhibitor that is now widely used for patients with metastatic malignant melanoma. However, this immune checkpoint inhibitor can induce related adverse events in various organs. Here, we report a case of bilateral drug (ipilimumab)-induced serous retinal detachment (SRD), and the characteristic features found during swept-source optical coherence tomography (SS-OCT).CaseA 78-year-old man with metastatic melanoma received 4 cycles of dacarbazine, nimustine, vincristine, and interferon-beta starting in January 2014, followed by 47 cycles of nivolumab starting in September 2014. Treatment with ipilimumab was started in June 2017. After 2 cycles of ipilimumab, the patient noticed impairment of the visual field in both of his eyes (at day 22) and visited our department in August 2017. Best corrected visual acuity at this initial visit was 16/20 in both eyes, while a fundus examination revealed SRD and retinal pigment epithelial detachments in both eyes. When using the horizontal and vertical 12 mm B-scanned images of SS-OCT, we detected SRD accompanied by a widely distributed high reflection of the photoreceptor outer segment, including the area where the SRD appeared. In addition, the image also showed the interdigitation zone was indistinguishable. Fluorescein angiography showed little leakage in the maculae. During his course of follow-up examinations, there was an increase in the SRD at the beginning, after which it then gradually decreased. However, the obscurity of the interdigitation zone remained.ConclusionIpilimumab may cause impairment of the outer retinal layer. We suggest that this is a presumed ipilimumab-induced SRD.

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Section: Discussionmentioning

confidence: 52%

“…For example, systemic complications such as type Ⅰ diabetes, hypothyroidism, hypopituitarism, colitis and hepatitis have been reported. Ophthalmologic complications have also been reported and include iridocyclitis, optic neuritis,2 chorioretinitis and Vogt-Koyanagi-Harada-like syndrome with impaired hearing and vitiligo 3…”

Section: Introductionmentioning

confidence: 99%

<p>A Case Of Ipilimumab-Induced Unusual Serous Retinal Detachment In Bilateral Eyes</p>

Miyakubo¹,

Mukai²,

Nakamura³

et al. 2019

IMCRJ

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“…However, with the advent of newer agents, the awareness and development of adverse event management are crucial . Of note, immune‐mediated uveitis has also been reported with nivolumab, another PD‐1 inhibitor, and ipilimumab …”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Pembrolizumab-Induced Uveitis in a Patient with Metastatic Melanoma

Hanna

2016

Pharmacotherapy

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Pembrolizumab, a programmed cell death protein 1 (PD-1) inhibitor, is a humanized monoclonal antibody used in the treatment of metastatic or unresectable melanoma and advanced non-small cell lung cancer (NSCLC). We hereby report a case of pembrolizumab-induced uveitis to increase practitioner awareness. A 78-year-old woman presented with onset of panuveitis after initiation of pembrolizumab therapy for metastatic melanoma. The patient received three cycles of therapy every 21 days, during which her symptoms progressively worsened. She was treated with topical and systemic corticosteroids, and further pembrolizumab was discontinued despite a good response to therapy. Pembrolizumab has been associated with rapid onset of ocular inflammation and uveitis. PD-1 inhibitors mediate a T-cell response against cancer cells; however, autoimmune complications have been reported. Incidence of pembrolizumab-induced uveitis is reported to be < 1%. To date, three cases have been reported since its Food and Drug Administration approval in September 2014. Uveitis, if left untreated, may lead to permanent vision loss and ocular damage. Cases of immune-mediated uveitis have been reported with cancer immunotherapies. Oncologists and ophthalmologists should be aware of this complication. With the increasing targeted pharmaceuticals in oncology, effective management of adverse events is necessary to ensure patient safety and optimal outcomes.

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“…Adverse events usually manifest in the form of skin inflammation ( 191 – 195 ), gastrointestinal disorders ( 196 – 200 ), hepatic malfunction ( 191 , 196 ), respiratory complications ( 186 , 197 ), and endocrine disorders ( 191 , 198 ). Rare manifestations such as sicca syndrome and arthritis ( 199 ), ocular inflammation ( 197 , 200 , 201 ), nephritis ( 202 – 204 ), heart disease ( 197 , 205 ), and meningitis ( 206 ) also occur. Various case studies and clinical trials have demonstrated that there is less toxicity and prolonged progression-free survival from the use of PD-1 checkpoint blockade compared to CTLA-4, in advanced melanoma, for instance ( 187 , 207 ).…”

Section: Immune Checkpoint Blockadementioning

confidence: 99%

Coinhibitory Receptor Expression and Immune Checkpoint Blockade: Maintaining a Balance in CD8+ T Cell Responses to Chronic Viral Infections and Cancer

et al. 2017

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In cancer and chronic viral infections, T cells are exposed to persistent antigen stimulation. This results in expression of multiple inhibitory receptors also called “immune checkpoints” by T cells. Although these inhibitory receptors under normal conditions maintain self-tolerance and prevent immunopathology, their sustained expression deteriorates T cell function: a phenomenon called exhaustion. Recent advances in cancer immunotherapy involve blockade of cytotoxic T lymphocyte antigen-4 and programmed cell death 1 in order to reverse T cell exhaustion and reinvigorate immunity, which has translated to dramatic clinical remission in many cases of metastatic melanoma and lung cancer. With the paucity of therapeutic vaccines against chronic infections such as HIV, HPV, hepatitis B, and hepatitis C, such adjunct checkpoint blockade strategies are required including the blockade of other inhibitory receptors such as T cell immunoreceptor with immunoglobulin (Ig) and immunoreceptor tyrosine-based inhibitory motif domains, T cell Ig and mucin-domain containing-3, lymphocyte activation gene 3, and V-domain Ig-containing suppressor of T cell activation. The nature of different chronic viral infections and cancers is likely to influence the level, composition, and pattern of inhibitory receptors expressed by responding T cells. This will have implications for checkpoint antibody blockade strategies employed for treating tumors and chronic viral infections. Here, we review recent advances that provide a clearer insight into the role of coinhibitory receptor expression in T cell exhaustion and reveal novel antibody-blockade therapeutic targets for chronic viral infections and cancer. Understanding the mechanism of T cell exhaustion in response to chronic virus infections and cancer as well as the nature of restored T cell responses will contribute to further improvement of immune checkpoint blockade strategies.

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Bilateral neuroretinitis and anterior uveitis following ipilimumab treatment for metastatic melanoma

Cited by 48 publications

References 18 publications

<p>A Case Of Ipilimumab-Induced Unusual Serous Retinal Detachment In Bilateral Eyes</p>

<p>A Case Of Ipilimumab-Induced Unusual Serous Retinal Detachment In Bilateral Eyes</p>

A Rare Case of Pembrolizumab-Induced Uveitis in a Patient with Metastatic Melanoma

Coinhibitory Receptor Expression and Immune Checkpoint Blockade: Maintaining a Balance in CD8+ T Cell Responses to Chronic Viral Infections and Cancer

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