Ocular and orbital side-effects of checkpoint inhibitors: a review article

Antoun, Joëlle; Titah, Chérif; Cochereau, Isabelle

doi:10.1097/cco.0000000000000296

Cited by 120 publications

(121 citation statements)

References 34 publications

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“…Ophthalmologic toxicity occurs in <1% of patients treated with ICI, and few case reports describing the ocular toxicities of ICI have been published to date . Manifestations vary and include uveitis, peripheral ulcerative keratitis, Vogt‐Koyanagi‐Harada syndrome, choroidal neovascularization, melanoma‐associated retinopathy, thyroid‐associated orbitopathy, and idiopathic orbital inflammation . The median onset occurs at 2 months .…”

Section: Checkpoint Inhibitorsmentioning

confidence: 99%

“…92 Manifestations vary and include uveitis, peripheral ulcerative keratitis, Vogt-Koyanagi-Harada syndrome, choroidal neovascularization, melanoma-associated retinopathy, thyroid-associated orbitopathy, and idiopathic orbital inflammation. 92 The median onset occurs at 2 months. 92 Presentation varies, and patients may develop worsening vision, floaters, or conjunctival injection.…”

Section: Ocular Toxicitymentioning

confidence: 99%

“…92 The median onset occurs at 2 months. 92 Presentation varies, and patients may develop worsening vision, floaters, or conjunctival injection. 11 Ocular toxicity is often seen in combination with extraocular irAEs, particularly colitis.…”

Section: Ocular Toxicitymentioning

confidence: 99%

See 2 more Smart Citations

A review of cancer immunotherapy toxicity

Kennedy

Salama

2020

CA A Cancer J Clinicians

915

699

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Cancer immunotherapies, including checkpoint inhibitors and adoptive cell therapy, manipulate the immune system to recognize and attack cancer cells. These therapies have the potential to induce durable responses in multiple solid and hematologic malignancies and thus have transformed treatment algorithms for numerous tumor types. Cancer immunotherapies lead to unique toxicity profiles distinct from the toxicities of other cancer therapies, depending on their mechanism of action. These toxicities often require specific management, which can include steroids and immune‐modulating therapy and for which consensus guidelines have been published. This review will focus on the toxicities of checkpoint inhibitors and chimeric antigen receptor T cells, including pathophysiology, diagnosis, and management.

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Section: Checkpoint Inhibitorsmentioning

confidence: 99%

Section: Ocular Toxicitymentioning

confidence: 99%

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A review of cancer immunotherapy toxicity

Kennedy

Salama

2020

CA A Cancer J Clinicians

915

699

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“…Median onset occurs at 2 months [72]. Few case reports describing the ocular toxicity of ICI have been published [72].…”

Section: Ocular Toxicitymentioning

confidence: 99%

A Review of Immune-Mediated Adverse Events in Melanoma

Kennedy

Salama

2019

Oncol Ther

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The use of checkpoint inhibitor-based immunotherapy has transformed the treatment landscape for melanoma as well as many other cancer types. With the ability to potentiate tumor-specific immune responses, these agents can result in durable tumor control. However, this activation of the immune system can lead to a unique constellation of side effects, distinct from other cancer therapies, collectively termed immune-mediated adverse events (irAEs). This review will focus on irAEs and guidelines for management related to the most clinically relevant checkpoint inhibitors, those that target programmed death receptor-1 (PD-1) and cytotoxic T lymphocyte antigen-4 (CTLA-4).

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“…Eine Beendigung der Therapie mit den Immun-Checkpoint-Inhibitoren sollte in der Regel nur bei einer schweren Augenbeteiligung erfolgen[2,[53][54][55]58].…”

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Nebenwirkungsmanagement bei Immun‐Checkpoint‐Blockade durch CTLA‐4‐ und PD‐1‐Antikörper beim metastasierten Melanom – ein Update

Kähler

Hassel

Heinzerling

et al. 2020

J Deutsche Derma Gesell

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EinleitungDie Immun-Checkpoint-Inhibition (ICI) hat die medikamentöse Tumortherapie in den letzten zehn Jahren revolutioniert, wobei das metastasierte Melanom bei der Entwicklung dieser Therapie die führende Indikation war [1]. Eine Vielzahl von Immun-Checkpoints sind bekannt. Zur Tumortherapie zugelassene Antikörper sind momentan verfügbar zur Blockade der Checkpoints CTLA-4 (cytotoxic T-lymphocyte antigen 4, Ipilimumab) und PD-1 (programmed cell death protein 1, Nivolumab, Pembrolizumab, Cemiplimab) beziehungsweise dessen Liganden PD-L1 (Avelumab, Atezolizumab, Durvalumab). Diese Antikörper werden bei zahlreichen Tumorentitäten eingesetzt, neben den Hauttumoren (Melanom, kutanes Plattenepithelkarzinom und Merkelzellkarzinom) gehören dazu Bronchial-, Mamma-, Nieren-, Leber-, Harnblasen-und Kopf-Hals-Tumoren. Der therapeutische Eingriff in die Regulation des Immunsystems hat aber auch Nebenwirkungen, die auf dem Wirkmechanismus beruhen. So kann es zu Entzündungen in unterschiedlichen Organen kommen, die teilweise lebensbedrohlich sein können und ein schnelles Handeln erfordern. Dieser Artikel bietet ein Update zu unserer Übersicht von 2016 [2] und soll den aktuellen Kenntnisstand zu den Nebenwirkungen und dem Management von Immun-Checkpoint-Inhibitoren zusammenfassen. Eine so intensivierte Immunantwort bringt unvermeidlich auch Nebenwirkungen mit sich. Das Wissen um dieses Nebenwirkungsspektrum ist für die Prophylaxe und das Management notwendig. Es kommt zu Nebenwirkungen wie Colitis, Dermatitis, Hypophysitis, Thyreoiditis, Hepatitis und weiteren, selteneren Autoimmunphänomenen. Die Erkennung und Therapie der genannten Autoimmunnebenwirkungen sind inzwischen gut bekannt. Insbesondere die frühe Diagnose seltener, aber mit einer höheren Letalität verbundenen neurologischen oder kardiologischen Nebenwirkungen ist häufig schwierig. Dieses Update beschreibt das aktuelle Nebenwirkungsspektrum und -Management unter Immun-Checkpoint-Inhibition sowie neue Erkenntnisse zu diesem Themenfeld. SummaryCTLA-4 and PD-1 play a key role in tumor-induced downregulation of lymphocytic immune responses. Immune checkpoint inhibitors have been shown to alter the immune response to various cancer types. Anti-CTLA-4 and anti-PD-1 antibodies affect the interaction between tumor, antigen-presenting cells and T lymphocytes. Clinical studies of the anti-CTLA-4 antibody ipilimumab and the anti-PD-1 antibodies nivolumab and pembrolizumab have provided evidence of their positive effects on overall survival in melanoma patients. Combined treatment using ipilimumab and nivolumab has been shown to achieve five-year survival rates of 52 %. Such enhancement of the immune response is inevitably associated with adverse events. Knowledge of the spectrum of side effects is essential, both in terms of prevention and management. Adverse events include colitis, dermatitis, hypophysitis, thyroiditis, hepatitis and other, less common autoimmune phenomena. In recent years, considerable progress has been made in the detection and treatment of the aforemention...

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Ocular and orbital side-effects of checkpoint inhibitors: a review article

Abstract: Physicians involved in the care of oncologic patients should be aware of the ocular and orbital IRAEs that may develop with checkpoint inhibitors. A strong cooperation between oncologists and ophthalmologists is required in the diagnosis and prompt management of these IRAEs.

Cited by 120 publications

References 34 publications

A review of cancer immunotherapy toxicity

A review of cancer immunotherapy toxicity

A Review of Immune-Mediated Adverse Events in Melanoma

Nebenwirkungsmanagement bei Immun‐Checkpoint‐Blockade durch CTLA‐4‐ und PD‐1‐Antikörper beim metastasierten Melanom – ein Update

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