Uveitis induced by programmed cell death protein 1 inhibitor therapy with nivolumab in metastatic melanoma patient

Kanno, Hiroaki; Ishida, Kyoko; Yamada, Wataru; Nishida, Takashi; Takahashi, Nobumichi; Mochizuki, Kiyofumi; Mizuno, Yuki; Matsuyama, Katsuhiko; Takahashi, Tomoko; Seishima, Mariko

doi:10.1016/j.jiac.2017.04.007

Cited by 36 publications

(13 citation statements)

References 13 publications

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“…Retinopathy and uveal effusions have been reported with anti-PD-1/PD-L1 agents. Both of these present with blurred vision, and uveal effusions can additionally cause a painful red eye [57, 58]. There have been case reports of patients who have received nivolumab developing Vogt–Koyanagi–Harada-like syndrome (uveomeningitis syndrome) [59].…”

Section: Ophthalmological Adverse Eventsmentioning

confidence: 99%

Toxicities associated with checkpoint inhibitors—an overview

2019

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Immunotherapy has an increasing role in the management of cancer, both in metastatic disease and as an adjuvant therapy. However, sensitization of the immune system with checkpoint inhibitors comes with a unique side effect profile. Full appreciation of this can take some time to emerge as some adverse events are rare, or can be subtle and potentially overlooked. Clinician awareness of these side effects can be particularly important in patients with pre-existing autoimmune conditions. Here we describe common symptoms and diagnostic strategies for organ-specific side effects of anti-CTLA-4 and anti-PD-1/PD-L1 immunotherapy agents.

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Section: Ophthalmological Adverse Eventsmentioning

confidence: 99%

Toxicities associated with checkpoint inhibitors—an overview

2019

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“…Anti-PD-1/PD-L1-induced uveitis presenting with conjunctival redness, eye pain, photophobia, floaters, and blurry vision has been reported [101]. Complete ophthalmologic examination, funduscopic examination, fluorescein angiography, optical coherence tomography, ultrasound biomicroscopy, and electrophysiological examination must be considered.…”

Section: Uveitismentioning

confidence: 99%

“…Retinopathy secondary to anti-PD-1/PD-L1 agents causing blurry vision has been described [101][102][103]. In these cases, cancer-associated retinopathy must be ruled out.…”

Section: Other Ocular Toxicitymentioning

confidence: 99%

Safety and Tolerability of Immune Checkpoint Inhibitors (PD-1 and PD-L1) in Cancer

et al. 2019

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Immunotherapy has emerged in recent years and has revolutionized the treatment of cancer. Immune checkpoint inhibitors, including anti-cytotoxic T lymphocyte antigen-4 (CTLA-4), anti-programmed cell death-1 (PD-1) and anti-programmed cell death ligand-1 (PD-L1) agents, are the first of this new generation of treatments. Anti-PD-1/PD-L1 agents target immune cells by blocking the PD-1/PD-L1 pathway. This blockade leads to enhancement of the immune system and therefore restores the tumour-induced immune deficiency selectively in the tumour microenvironment. However, this shift in the balance of the immune system can also produce adverse effects that involve multiple organs. The pattern of toxicity is different from traditional chemotherapy agents or targeted therapy, and there is still little experience in recognizing and managing it. Thus, toxicity constitutes a real clinical management challenge and any new alteration should be suspected of being treatmentrelated. The most common toxicities occur in the skin, gastrointestinal tract, lungs, and endocrine, musculoskeletal, renal, nervous, haematologic, cardiovascular and ocular systems. Immune-mediated toxic effects are usually manageable, but toxicities may sometimes lead to treatment withdrawal, and even fulminant and fatal events can occur. Oncologists need to collaborate with internists, clinical immunologists and other specialists to understand, manage and prevent toxicity derived from immunotherapy. This review focuses on the mechanisms of toxicity of anti-PD-1/PD-L1 agents, and its diagnosis and management.

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“…All clinical features of the above-mentioned three types of uveitis were revealed in panuveitis ( Table 3 ). Moreover, Vogt-Koyanagi-Harada disease is a common ocular irAE associated with ICIs ( 45 , 58 , 105 ). It is a type of bilateral granulomatous uveitis, associated with exudative retinal detachment and extraocular manifestations, such as pleocytosis in the cerebrospinal fluid and, in some cases, vitiligo, poliosis, alopecia, and dysacusis.…”

Section: Clinical Characteristic Of Ocular Iraes In Lung Cancer With Icismentioning

confidence: 99%

Ocular Immune-Related Adverse Events Associated With Immune Checkpoint Inhibitors in Lung Cancer

Zhou

Wei

2021

Front. Immunol.

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Immune checkpoint inhibitors (ICIs) are novel immunotherapy-based drugs that have become increasingly popular in the treatment of lung cancer. Researchers have recognized ocular immune-related adverse events (irAEs) secondary to ICIs because of their vision-threatening characteristics. However, they are incompletely characterized and no studies have reported the ICI-related ocular irAEs in lung cancer. Therefore, we aimed to comprehensively illustrate the clinical characteristics, contributory factors, diagnosis, and management of ICI-related ocular irAEs in lung cancer, based on previously reported 79 patients. Ophthalmoplegia (40.51%), uveitis (20.25%), and dry eye (17.72%) were the most common ICI-related ocular irAEs in lung cancer. Ptosis was the most common (36.71%) and the highest mortality (23.33%) of ophthalmoplegia. Patients in Asia and patients who underwent combination therapy with programmed cell death-1 and cytotoxic T-lymphocyte-associated antigen 4 inhibitors demonstrated significantly higher frequency of ophthalmoplegia than other ocular irAEs. Most ICI-related ophthalmoplegia and uveitis in lung cancer were observed in the first 10 weeks following the initiation of ICIs. Furthermore, the onset time of dry eye and other ocular irAEs was much longer. In addition, 92.31% of the patients with ocular irAEs other than ophthalmoplegia could be remised. In conclusion, ocular irAEs secondary to ICIs in lung cancer are non-negligible, particularly ophthalmoplegia. Ethnicity and the type of ICIs play important roles in the distribution of ocular irAEs. ICI-related ophthalmoplegia in lung cancer presented with early onset and worse prognosis features, thus necessitating further attention.

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Uveitis induced by programmed cell death protein 1 inhibitor therapy with nivolumab in metastatic melanoma patient

Cited by 36 publications

References 13 publications

Toxicities associated with checkpoint inhibitors—an overview

Toxicities associated with checkpoint inhibitors—an overview

Safety and Tolerability of Immune Checkpoint Inhibitors (PD-1 and PD-L1) in Cancer

Ocular Immune-Related Adverse Events Associated With Immune Checkpoint Inhibitors in Lung Cancer

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