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Ophthalmic immune-related adverse events associated with immune checkpoint inhibitors

PURPOSE: To investigate the incidence of immune-related adverse events (irAEs) of immune checkpoint inhibitor (ICI) therapy and to report the clinical features, management, and outcomes of ophthalmic irAEs. METHODS: We retrospectively reviewed the medical records of patients who received ICI therapy...

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Autores principales: Gan, Linyang, Chen, Huan, Liu, Xiaowei, Zhang, Li
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10076523/
https://www.ncbi.nlm.nih.gov/pubmed/37033964
http://dx.doi.org/10.3389/fimmu.2023.1130238
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author Gan, Linyang
Chen, Huan
Liu, Xiaowei
Zhang, Li
author_facet Gan, Linyang
Chen, Huan
Liu, Xiaowei
Zhang, Li
author_sort Gan, Linyang
collection PubMed
description PURPOSE: To investigate the incidence of immune-related adverse events (irAEs) of immune checkpoint inhibitor (ICI) therapy and to report the clinical features, management, and outcomes of ophthalmic irAEs. METHODS: We retrospectively reviewed the medical records of patients who received ICI therapy from January 2016 to September 2022 at Peking Union Medical College Hospital and analyzed the incidence of systemic and ophthalmic adverse effects of this therapy. RESULTS: Of 962 patients, 248 (25.8%) experienced irAEs. The first-year incidences of total irAEs and ophthalmic irAEs were 23.5% and 1.1%. The most common ICI received by the patients was pembrolizumab (373; 38.8%). Nearly half of the patients (477; 49.6%) had lung cancer. Combination therapy was associated with an increased incidence of irAEs without statistical significance. Patients with lung cancer presented with an increased incidence of total irAEs (p = 0.003) and ophthalmic irAEs (p = 0.032). Eleven patients had ophthalmic manifestations, including ophthalmoplegia (6/11), conjunctivitis (3/11), reactive cutaneous capillary endothelial proliferation (RCCEP) (1/11), and orbital inflammation (1/11). Eight patients had concomitant extra-ophthalmic irAEs. Furthermore, ICIs were discontinued in nine patients, and most ophthalmic manifestations were well controlled with topical and systemic steroids. Ten patients were treated with intravenous or oral steroids. However, cancer progression occurred in five out of eleven patients after the interruption of ICIs. CONCLUSION: IrAEs are correlated with ICI regimens and underlying neoplasia. In our Chinese cohort, patients have a higher risk of ophthalmoplegia than uveitis. Early recognition and multidisciplinary consultation are crucial for optimal treatment of ophthalmic irAEs.
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spelling pubmed-100765232023-04-07 Ophthalmic immune-related adverse events associated with immune checkpoint inhibitors Gan, Linyang Chen, Huan Liu, Xiaowei Zhang, Li Front Immunol Immunology PURPOSE: To investigate the incidence of immune-related adverse events (irAEs) of immune checkpoint inhibitor (ICI) therapy and to report the clinical features, management, and outcomes of ophthalmic irAEs. METHODS: We retrospectively reviewed the medical records of patients who received ICI therapy from January 2016 to September 2022 at Peking Union Medical College Hospital and analyzed the incidence of systemic and ophthalmic adverse effects of this therapy. RESULTS: Of 962 patients, 248 (25.8%) experienced irAEs. The first-year incidences of total irAEs and ophthalmic irAEs were 23.5% and 1.1%. The most common ICI received by the patients was pembrolizumab (373; 38.8%). Nearly half of the patients (477; 49.6%) had lung cancer. Combination therapy was associated with an increased incidence of irAEs without statistical significance. Patients with lung cancer presented with an increased incidence of total irAEs (p = 0.003) and ophthalmic irAEs (p = 0.032). Eleven patients had ophthalmic manifestations, including ophthalmoplegia (6/11), conjunctivitis (3/11), reactive cutaneous capillary endothelial proliferation (RCCEP) (1/11), and orbital inflammation (1/11). Eight patients had concomitant extra-ophthalmic irAEs. Furthermore, ICIs were discontinued in nine patients, and most ophthalmic manifestations were well controlled with topical and systemic steroids. Ten patients were treated with intravenous or oral steroids. However, cancer progression occurred in five out of eleven patients after the interruption of ICIs. CONCLUSION: IrAEs are correlated with ICI regimens and underlying neoplasia. In our Chinese cohort, patients have a higher risk of ophthalmoplegia than uveitis. Early recognition and multidisciplinary consultation are crucial for optimal treatment of ophthalmic irAEs. Frontiers Media S.A. 2023-03-23 /pmc/articles/PMC10076523/ /pubmed/37033964 http://dx.doi.org/10.3389/fimmu.2023.1130238 Text en Copyright © 2023 Gan, Chen, Liu and Zhang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Gan, Linyang
Chen, Huan
Liu, Xiaowei
Zhang, Li
Ophthalmic immune-related adverse events associated with immune checkpoint inhibitors
title Ophthalmic immune-related adverse events associated with immune checkpoint inhibitors
title_full Ophthalmic immune-related adverse events associated with immune checkpoint inhibitors
title_fullStr Ophthalmic immune-related adverse events associated with immune checkpoint inhibitors
title_full_unstemmed Ophthalmic immune-related adverse events associated with immune checkpoint inhibitors
title_short Ophthalmic immune-related adverse events associated with immune checkpoint inhibitors
title_sort ophthalmic immune-related adverse events associated with immune checkpoint inhibitors
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10076523/
https://www.ncbi.nlm.nih.gov/pubmed/37033964
http://dx.doi.org/10.3389/fimmu.2023.1130238
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