Uveitis in Patients Treated with CTLA-4 and PD-1 Checkpoint Blockade Inhibition. (17th February 2020)

• Record Type: Journal Article
• Authors: Sun, Michel M.; Levinson, Ralph D.; Filipowicz, Artur; Anesi, Stephen; Kaplan, Henry J.; Wang, Wei; Goldstein, Debra A.; Gangaputra, Sapna; Swan, Robert T.; Sen, H. Nida; Gordon, Lynn K.
• Is Part Of: Ocular immunology and inflammation. Volume 28:Number 2(2020)
• Page Start: 217
• Page End: 227
• Publication Date: 2020-02-17
• Subjects: Checkpoint inhibitor -- CTLA-4 -- immunotherapy -- ocular inflammation -- PD-1 -- uveitis; Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.1080/09273948.2019.1577978
• Languages: English
• ISSNs: 0927-3948

Abstract

ABSTRACT: Purpose : To investigate the link between treatment with CTLA-4 and PD-1 checkpoint blockade inhibitors and the development of noninfectious uveitis. Methods : A survey was distributed to uveitis specialists to identify patients who developed uveitis while receiving either PD-1 inhibitors pembrolizumab and nivolumab; PD-L1 inhibitors atezolizumab, avelumab, and durvalumab; or the CTLA-4 inhibitor ipilimumab. Results : Fifteen patients from seven institutions were identified. The most common cancer diagnosis (13/15) was malignant melanoma. Fourteen patients had a new uveitis diagnosis following checkpoint blockade administration (six anterior uveitis, six panuveitis, one posterior uveitis, one anterior/intermediate combined); one patient developed optic neuritis. Uveitis was diagnosed within 6 months after drug initiation for 11/12 patients (median 63 days). Corticosteroid treatment was effective for most patients, although two patients had permanent loss of vision. Conclusions : Patients on checkpoint inhibitor therapy should be educated to seek care if they develop ocular symptoms, and prompt referral to specialists should be incorporated into oncology protocols.