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Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis

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Dual checkpoint inhibitor-associated eosinophilic enteritis.

J Yang¹, S M Lagana², Y M Saenger^1,3

¹Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Journal for Immunotherapy of Cancer

|November 16, 2019

Summary

Immune checkpoint inhibitors can cause hypereosinophilia, a rare side effect. This case highlights eosinophilic enteritis in melanoma patients treated with dual inhibitors, successfully managed with steroids.

Keywords:

Checkpoint inhibition Eosinophilia Eosinophilic enteritis Melanoma

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Area of Science:

Oncology
Immunology
Gastroenterology

Background:

Immune checkpoint inhibitors (ICIs) offer novel cancer treatment strategies.
Eosinophilia is a recognized, albeit rare, biological effect of ICIs.
ICIs can induce immune-related adverse events affecting various organs.

Observation:

A patient with advanced cutaneous melanoma developed hypereosinophilia and eosinophilic enteritis.
The patient was treated with a combination of ipilimumab and nivolumab.
Symptoms included gastrointestinal distress associated with eosinophilic infiltration.

Findings:

Dual ICI therapy (ipilimumab plus nivolumab) was linked to hypereosinophilia and enteritis.
Steroid administration led to rapid resolution of peripheral eosinophilia and symptoms.
This represents the first reported case of ICI-induced eosinophilic enteritis with this specific drug combination.

Implications:

Clinicians should consider eosinophilia in patients on dual ICI therapy presenting with gastrointestinal symptoms.
Early recognition and management of ICI-induced eosinophilia are crucial.
This case expands the spectrum of known immune-related adverse events associated with combination ICI therapy.