Panuveitis in patient on ipilimumab/nivolumab combination for small-cell lung cancer treated with an intravitreal dexamethasone implant. (July 2021)

• Record Type: Journal Article
• Authors: L Hefler, Jade; M Bailey, Lauren; El Rahi, Cynthia; C Schefler, Amy; Bernicker, Eric H
• Is Part Of: Journal of oncology pharmacy practice. Volume 27:Number 5(2021)
• Page Start: 1261
• Page End: 1264
• Publication Date: 2021-07
• Subjects: Immunotherapy -- immune-related adverse event -- checkpoint inhibitor -- panuveitis; Cancer -- Chemotherapy -- Periodicals; Clinical pharmacology -- Periodicals; 616.994061
• DOI: 10.1177/1078155220969792
• Languages: English
• ISSNs: 1078-1552

Abstract

Background: Immunotherapy with checkpoint inhibitors has demonstrated durable responses and remarkable antitumor effects in a variety of cancers. Although these agents are generally well-tolerated, patients can experience immune-related adverse events (irAEs) that require prompt recognition by healthcare providers. Immune-related ocular toxicities are rare, but serious adverse events have been reported with the use of checkpoint inhibitors. Case presentation: Here, we describe a rare case of panuveitis during Nivolumab and Ipilimumab combination treatment in a patient being treated for recurrent Small Cell Lung Cancer (SCLC). The patient was managed with an injection of Ozurdex (Allergan, Madison, NJ), a dexamethasone intravitreal implant. The patient had a resolution of inflammation and an improvement in her vision and was able to resume nivolumab monotherapy without recurrence of the panuveitis. Conclusion: This case highlights the importance of early recognition of ocular irAEs by ocular oncologists and the successful approach to treatment of immunotherapy-induced panuveitis in order to avoid permanent cessation of therapy.