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Uveitis in Patients Treated with CTLA-4 and PD-1 Checkpoint Blockade Inhibition.


ABSTRACT: Purpose: To investigate the link between treatment with CTLA-4 and PD-1 checkpoint blockade inhibitors and the development of noninfectious uveitis.Methods: A survey was distributed to uveitis specialists to identify patients who developed uveitis while receiving either PD-1 inhibitors pembrolizumab and nivolumab; PD-L1 inhibitors atezolizumab, avelumab, and durvalumab; or the CTLA-4 inhibitor ipilimumab.Results: Fifteen patients from seven institutions were identified. The most common cancer diagnosis (13/15) was malignant melanoma. Fourteen patients had a new uveitis diagnosis following checkpoint blockade administration (six anterior uveitis, six panuveitis, one posterior uveitis, one anterior/intermediate combined); one patient developed optic neuritis. Uveitis was diagnosed within 6 months after drug initiation for 11/12 patients (median 63 days). Corticosteroid treatment was effective for most patients, although two patients had permanent loss of vision.Conclusions: Patients on checkpoint inhibitor therapy should be educated to seek care if they develop ocular symptoms, and prompt referral to specialists should be incorporated into oncology protocols.

SUBMITTER: Sun MM 

PROVIDER: S-EPMC6832811 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Uveitis in Patients Treated with CTLA-4 and PD-1 Checkpoint Blockade Inhibition.

Sun Michel M MM   Levinson Ralph D RD   Filipowicz Artur A   Anesi Stephen S   Kaplan Henry J HJ   Wang Wei W   Goldstein Debra A DA   Gangaputra Sapna S   Swan Robert T RT   Sen H Nida HN   Gordon Lynn K LK  

Ocular immunology and inflammation 20190301 2


<i>Purpose</i>: To investigate the link between treatment with CTLA-4 and PD-1 checkpoint blockade inhibitors and the development of noninfectious uveitis.<i>Methods</i>: A survey was distributed to uveitis specialists to identify patients who developed uveitis while receiving either PD-1 inhibitors pembrolizumab and nivolumab; PD-L1 inhibitors atezolizumab, avelumab, and durvalumab; or the CTLA-4 inhibitor ipilimumab.<i>Results</i>: Fifteen patients from seven institutions were identified. The  ...[more]

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