期刊
JOURNAL OF IMMUNOTHERAPY
卷 44, 期 5, 页码 193-197出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/CJI.0000000000000367
关键词
immune checkpoint inhibitors; immune-related adverse event; melanoma; otovestibular dysfunction; uveitis
资金
- Bristol-Myers Squibb
- Immunocore
- MSD
- Novartis
- Roche
- Sanofi
In high-risk melanoma patients treated with immune checkpoint inhibitors, a high percentage experience immune-related adverse events, with some cases classified as severe or life-threatening. Common symptoms include diarrhea, fatigue, hypothyroidism, and hepatitis. Rare cases may involve otovestibular dysfunction and uveitis, with unclear pathogenic mechanisms.
Immune-related adverse events have been described in 86%-96% of high-risk melanoma patients treated with immune checkpoint inhibitors (ICI), while in 17%-59% of cases these are classified as severe or even life-threatening. The most common immune-related adverse events include diarrhea, fatigue, hypothyroidism, and hepatitis. Bilateral uveitis and unspecific vertigo have been described in 1% of cases, respectively, in the pivotal studies of ICIs, but the affection of the vestibule-cochlear system has not been reported before. In this case series, we present 3-stage IV melanoma patients with sudden onset of otovestibular dysfunction (hearing loss and vestibulopathy), partly combined with uveitis because of ICIs. We describe detailed diagnostic work-up and therapeutic interventions and discuss possible pathogenic mechanisms of this rare and disabling event.
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