Uveitis Associated with Cancer Immunotherapy: Long-Term Outcomes

Fardeau, Christine; Bencheqroun, Mehdi; Lévy, Arielle; Bonnin, Sophie; Ferchaud, Marie-Adélaïde; Fardeau, Leila; Coscas, Florence; Bodaghi, Bahram; Lebrun‐Vignes, Bénédicte

doi:10.2217/imt-2021-0032

Cited by 4 publications

(5 citation statements)

References 65 publications

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“…In a retrospective case series of eight patients treated with different cancer immunotherapies, including 4 treated with ICIs, local corticosteroids allowed good control of ocular inflammatory activity. In patients who continued their ICI therapy, sub-Tenon triamcinolone injections effectively treated uveitis and avoided ICI discontinuation and systemic corticosteroids [202]. Systemic corticosteroids were proven effective in the treatment of ICI-associated uveitis by numerous studies [100,202,203].…”

Section: Treatment Options 81 Topical Steroids and Systemic Corticost...mentioning

confidence: 99%

“…In patients who continued their ICI therapy, sub-Tenon triamcinolone injections effectively treated uveitis and avoided ICI discontinuation and systemic corticosteroids [202]. Systemic corticosteroids were proven effective in the treatment of ICI-associated uveitis by numerous studies [100,202,203]. Typically, when there is posterior involvement, systemic corticosteroids are initiated as a first-line treatment with a possible association of immunosuppressors, immunomodulators, or biologics.…”

Section: Treatment Options 81 Topical Steroids and Systemic Corticost...mentioning

confidence: 99%

“…Preventing recurrence of uveitis is challenging when ICIs are continued or re-introduced. The long-term use of dexamethasone drops once uveitis control is achieved has been suggested, to maintain low ocular inflammation activity [202]. Another proposed strategy is the re-injection of corticosteroids in cases of persisting posterior segment involvement [72].…”

Section: Management Of Refractory Casesmentioning

confidence: 99%

“…Similarly, in Fardeau et al's case series of patients treated with nivolumab and ipilimumab, at three months, outcomes were favorable with a local corticosteroid treatment regardless of whether the ICI was suspended or not. At 12 months, however, ICI continuation was associated with persistent ocular inflammatory activity, which responded well to triamcinolone sub-Tenon injections [202]. Many studies highlight the tendency of ICI-related uveitis to recur when ICIs are continued or re-introduced despite a satisfactory initial response to corticosteroids [129].…”

Section: Prognosis and Complicationsmentioning

confidence: 99%

“…A standard questionnaire may be provided to the oncology team and the patient to facilitate the recognition of ophthalmic red flags. Decisions relative to the treatment of ocular adverse events should be made by consensus in a multidisciplinary meeting to ensure an optimized and individualized therapeutic strategy [202]; (6) Ophthalmologists should stay aware of ocular metastatic disease. Despite the eye's immune privilege, metastatic disease can reach ocular and periocular tissues.…”

Section: Recommendations For Clinical Practice and Researchmentioning

confidence: 99%

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Diagnosing and Managing Uveitis Associated with Immune Checkpoint Inhibitors: A Review

Zhang,

Houadj,

et al. 2024

Diagnostics

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This review aims to provide an understanding of the diagnostic and therapeutic challenges of uveitis associated with immune checkpoint inhibitors (ICI). In the wake of these molecules being increasingly employed as a treatment against different cancers, cases of uveitis post-ICI therapy have also been increasingly reported in the literature, warranting an extensive exploration of the clinical presentations, risk factors, and pathophysiological mechanisms of ICI-induced uveitis. This review further provides an understanding of the association between ICIs and uveitis, and assesses the efficacy of current diagnostic tools, underscoring the need for advanced techniques to enable early detection and accurate assessment. Further, it investigates the therapeutic strategies for ICI-related uveitis, weighing the benefits and limitations of existing treatment regimens, and discussing current challenges and emerging therapies in the context of their potential efficacy and side effects. Through an overview of the short-term and long-term outcomes, this article suggests recommendations and emphasizes the importance of multidisciplinary collaboration between ophthalmologists and oncologists. Finally, the review highlights promising avenues for future research and development in the field, potentially informing transformative approaches in the ocular assessment of patients under immunotherapy and the management of uveitis following ICI therapy.

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Section: Treatment Options 81 Topical Steroids and Systemic Corticost...mentioning

confidence: 99%

Section: Treatment Options 81 Topical Steroids and Systemic Corticost...mentioning

confidence: 99%

Section: Management Of Refractory Casesmentioning

confidence: 99%

Section: Prognosis and Complicationsmentioning

confidence: 99%

Section: Recommendations For Clinical Practice and Researchmentioning

confidence: 99%

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Diagnosing and Managing Uveitis Associated with Immune Checkpoint Inhibitors: A Review

Zhang,

Houadj,

et al. 2024

Diagnostics

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Survivorship outcomes in patients treated with immune checkpoint inhibitors: a scoping review

Güven,

Thong,

Arndt

2024

J Cancer Surviv

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Background Immune checkpoint inhibitors (ICIs) have become a central part of cancer care. However, the survivorship outcomes in patients treated with ICIs are understudied. Therefore, we conducted a scoping review to evaluate the current status of the field and to establish research gaps regarding survivorship outcomes with ICIs in real-life cohorts. Methods We used the Web of Science, PubMed, and Embase databases to systematically filter published studies with real-life cohorts from January 1, 2010, until October 19, 2022. Studies evaluating at least one survivorship outcome in ICI-treated patients were included. Results A total of 39 papers were included. Quality of life (QoL) (n = 23), toxicity burden (n = 16), and psychosocial issues (n = 9) were the most frequently evaluated survivorship outcomes. Anti-PD-1/PD-L1 monotherapy and a response to treatment were associated with better QoL. In addition, the ICIs were associated with grade 3 or higher immune-related adverse events (irAEs) in 10–15% and late/long-term irAEs in 20–30% of the survivors. Regarding psychosocial problems, over 30% of survivors showed evidence of anxiety and depression, and 30–40% of survivors reported neurocognitive impairments. Conclusion The survivors treated with ICIs have impairments in most survivorship domains. Further research is needed to gather data on the understudied survivorship outcomes like late and long-term effects, fertility, financial toxicity, and return to work in survivors treated with ICIs. Implications for Cancer Survivors Available evidence demonstrates that a significant portion of survivors treated with ICIs have a significant toxicity burden, lower QoL than the general population, and a high rate of psychosocial problems.

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Multiple drugs

2022

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Uveitis Associated with Cancer Immunotherapy: Long-Term Outcomes

Cited by 4 publications

References 65 publications

Diagnosing and Managing Uveitis Associated with Immune Checkpoint Inhibitors: A Review

Diagnosing and Managing Uveitis Associated with Immune Checkpoint Inhibitors: A Review

Survivorship outcomes in patients treated with immune checkpoint inhibitors: a scoping review

Multiple drugs

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