Cytomegalovirus Infections in Patients Treated With Immune Checkpoint Inhibitors for Solid Malignancies

Abstract

Cytomegalovirus (CMV) infection/disease has been repeatedly reported in patients treated with immune-checkpoint inhibitors (ICIs) and most commonly involves patients with relapsed/refractory (R/R) immune-related adverse events (irAEs). In the current study we present a melanoma patient that developed CMV gastritis during treatment with pembrolizumab in the absence of irAEs and without previous or current immunosuppression. Moreover, we review the literature regarding CMV infection/disease in patients treated with ICIs for solid malignancies. We present the currently available data on the pathogenesis, clinical characteristics, endoscopic findings, and histologic features and highlight the potential differences among cases complicating R/R irAEs versus those occurring in immunosuppression-naïve patients. Finally, we discuss the currently available data regarding potential useful diagnostic tools as well as the management of these patients.