Ipilimumab-Induced Sarcoidosis and Thyroiditis

Nandavaram, Sravanthi; Nadkarni, Anupa

doi:10.1097/mjt.0000000000000545

Cited by 18 publications

(7 citation statements)

References 10 publications

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“…A total of 183 articles matched the search equation. Of these, 45 were related to cases of granulomatosis occurring during ICI treatment for melanoma with information on oncologic follow-up [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ]. A total of 67 patients were described, with a majority of men (55%) and a mean age at diagnosis of melanoma of 58 years.…”

Section: Resultsmentioning

confidence: 99%

Sarcoid-like Granulomatosis Associated with Immune Checkpoint Inhibitors in Melanoma

Melin

Routier

Roy

et al. 2022

Cancers

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We aimed to review the clinical and biological presentation of granulomatosis associated with immune-checkpoint inhibitors (ICI) in patients with melanoma and to explore its association with classical sarcoidosis as well as with cancer response to ICI. To this end, a retrospective study on 18 melanoma patients with histologically proven ICI-induced granulomatosis over a 12-year period in a single center, as well as on 67 similar cases reported in the literature, was conducted. Results indicate ICI-induced granulomatosis is an early side effect (median time to onset: 2 months). Its clinical presentation, with predominant (90%) thoracic involvement, histopathological appearance and supposed underlying biology (involving the mTOR pathway in immune cells, Th17 polarization and TReg dysfunction) are indistinguishable from those of sarcoidosis. Moreover, it appears to be associated with ICI benefit (>65% objective response rate). Evolution is generally favorable, and symptomatic steroid treatment and/or ICI discontinuation are rarely necessary. ICI-associated granulomatosis is critical to explore for several reasons. Practically, it is essential to differentiate it from cancer progression. Secondly, this “experimental” sarcoidosis brings new elements that may help to address sarcoidosis origin and pathophysiology. Its association with ICI efficacy must be confirmed on a larger scale but could have significant impacts on patient management and biomarker definition.

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Section: Resultsmentioning

confidence: 99%

Sarcoid-like Granulomatosis Associated with Immune Checkpoint Inhibitors in Melanoma

Melin

Routier

Roy

et al. 2022

Cancers

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“…Notably, some authors observed that in a patient with ICI-induced sarcoidosis the suspension of the drug alone achieved the complete resolution of the metabolically active lymph nodes without the need of additional steroid treatment [ 52 ]. Recently, some authors reviewed the cases of 26 patients developing granulomatous/sarcoid-like lesions associated with ICIs.…”

Section: Resultsmentioning

confidence: 99%

Musculoskeletal and Rheumatic Diseases Induced by Immune Checkpoint Inhibitors: A Review of the Literature

Benfaremo

Manfredi

Luchetti

et al. 2018

CDS

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Background: Immune checkpoint inhibitors are a new promising class of antitumor drugs that have been associated with a number of immune-related Adverse Events (AEs), including musculoskeletal and rheumatic disease.Methods: We searched Medline reviewing reports of musculoskeletal and rheumatic AEs induced by immune checkpoint inhibitors.Results: Several musculoskeletal and rheumatic AEs associated with immune checkpoint inhibitors treatment are reported in the literature. In particular, arthralgia and myalgia were the most common reported AEs, whereas the prevalence of arthritis, myositis and vasculitis is less characterized and mainly reported in case series and case reports. Other occasionally described AEs are sicca syndrome, polymyalgia rheumatica, systemic lupus erythematosus and sarcoidosis.Conclusion: Newly induced musculoskeletal and rheumatic diseases are a frequent adverse event associated with immune checkpoint inhibitors treatment

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“…However, there is an on‐going controversy in regards with the relationship between sarcoidosis and malignancies, given that sarcoidosis may develop during the course of an oncologic disease and vice versa 1 . Furthermore, sarcoidosis, or sarcoid‐like reactions (SLRs) may develop in association to certain oncologic drugs, including immune checkpoint inhibitors (ICIs) 1,3‐54 . As expected, the aforementioned facts raise significant diagnostic and therapeutic challenges in oncologic patients treated with ICIs.…”

Section: Introductionmentioning

confidence: 99%

Challenges in sarcoidosis and sarcoid‐like reactions associated to immune checkpoint inhibitors: A narrative review apropos of a case

Apalla

Kemanetzi

Papageorgiou

et al. 2020

Dermatologic Therapy

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Sarcoidosis and sarcoid‐like reactions (SLRs) may develop in association with various malignancies, as well as in association to certain oncologic drugs, including immune checkpoint inhibitors (ICIs). We aimed to perform a narrative review with regard to the development of ICIs‐associated sarcoidosis or SLRs, and to discuss the corresponding diagnostic and therapeutic challenges raised in this scenario. Apropos of a melanoma patient developing SLRs while treated with ipilimumab and nivolumab, we searched for clinically evident, ICIs‐associated sarcoidosis or SLRs in the English literature. We recorded the oncologic characteristics, including type of malignancy and type of ICI, the phenotypic characteristics of sarcoidosis/SLRs, as well as the impact on immunotherapy. Including our patient, we identified 80 ICIs‐associated sarcoidosis or SLRs cases. Both sexes were equally affected (40 F/40 M) and the most common malignancy was melanoma (65/80, 81.3%). Concerning the oncologic treatment, there was a predilection for pembrolizumab (23/80, 28.7%), followed by the ipilimumab/nivolumab combination (21/80, 26.3%), ipilimumab (18/80, 22.5%), nivolumab (16/80, 20.0%). Although in the majority of the cases (52/80, 65.0%) there was no need for systemic prednisolone for the management of sarcoidosis, a significant proportion of patients finally discontinued ICIs treatment (44/80, 55.0%). Phenotypically, sarcoidosis and SLRs highly imitate oncologic progression posing diagnostic difficulties. A therapeutic dilemma is also raised when there is a need for systemic prednisolone, since the latter may jeopardize the therapeutic efficacy of immunotherapy. Sarcoidosis and SLRs, though rare, can present in oncologic patients treated with ICIs. Clinicians should be aware of this possibility and the related diagnostic and therapeutic challenges they have to face in this scenario.

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Ipilimumab-Induced Sarcoidosis and Thyroiditis

Cited by 18 publications

References 10 publications

Sarcoid-like Granulomatosis Associated with Immune Checkpoint Inhibitors in Melanoma

Sarcoid-like Granulomatosis Associated with Immune Checkpoint Inhibitors in Melanoma

Musculoskeletal and Rheumatic Diseases Induced by Immune Checkpoint Inhibitors: A Review of the Literature

Challenges in sarcoidosis and sarcoid‐like reactions associated to immune checkpoint inhibitors: A narrative review apropos of a case

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