Immunotherapy‐induced sarcoidosis in patients with melanoma treated with PD‐1 checkpoint inhibitors: Case series and immunophenotypic analysis

Abstract

Our findings support prior literature implicating Th17.1 cells in the pathogenesis of sarcoidosis. However, we demonstrate these findings in patients with melanoma prior to administration of checkpoint therapy and before the onset of clinically symptomatic sarcoidosis. The identification of elevated Th17.1 cells in melanoma patients who have not developed sarcoidosis may reflect the established association between melanoma and sarcoidosis. With some patients receiving these agents over a prolonged period, the clinical course of immunotherapy-induced sarcoidosis is uncertain.

Immune checkpoint inhibitor-associated interstitial lung diseases: some progress but still many issues

“…Notably, it was not possible to describe a suggestive pattern in a third of the patients. This variability in presentation, in conjunction with previous reports of sarcoidosis-like manifestations [5], suggests an individual-specific pulmonary response to a common initial trigger (i.e. an ICI).…”

Pembrolizumab‐induced sarcoidal infusion site reaction

“…Granulomatous sarcoidosis‐like processes affecting the lungs, lymph nodes, and skin have previously been reported in patients receiving PD‐1 inhibitor therapy, both with pembrolizumab and nivolumab . Cutaneous sarcoidal reactions have also been described following treatment with ipilimumab, an inhibitor of cytotoxic T‐lymphocyte‐associated antigen .…”

“…[3][4][5] Granulomatous sarcoidosis-like processes affecting the lungs, lymph nodes, and skin have previously been reported in patients receiving PD-1 inhibitor therapy, both with pembrolizumab and nivolumab. [6][7][8][9] Cutaneous sarcoidal reactions have also been described following treatment with ipilimumab, an inhibitor of cytotoxic T-lymphocyte-associated antigen. 10 In these reported cases, Awareness of a potential sarcoidal reaction in the treatment of metastatic melanoma is particularly critical in that sarcoidosis can closely mimic the signs and symptoms of metastatic melanoma.…”

Utilizing state‐of‐the‐art “omics” technology and bioinformatics to identify new biological mechanisms and biomarkers for coronary artery disease

“…This generates a leukocyte “signature” in which the number and functional status of each subset indicates past and present inflammation and immune activity. This approach has been previously used to determine differences in melanoma patients' immune signatures following therapy with immune checkpoint inhibitors, and may be able to identify patients at specific risk of certain autoimmune complications . As cardiovascular disease has a definite inflammatory component, a characteristic profile of immune cell changes could potentially give similar information regarding the extent of disease and risk to the patient, particularly when used in conjunction with cytokine profiling.…”

“…This approach has been previously used to determine differences in melanoma patients' immune signatures following therapy with immune checkpoint inhibitors, and may be able to identify patients at specific risk of certain autoimmune complications. 31,32 As cardiovascular disease has a definite inflammatory component, a characteristic profile of immune cell changes could potentially give similar information regarding the extent of disease and risk to the patient, particularly when used in conjunction with cytokine profiling. Improvements in computational approaches to bioinformatics allows for the complex datasets that are produced to be integrated and studied against the clinical phenotype.…”