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Uveitis in Tumor Patients Treated with Immunological Checkpoint- and Signal Transduction Pathway-Inhibitors
Stephan Thurau1, Hendrik Engelke1, Peter McCluskey2
1Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany.
Purpose:
New tumor therapies like immune checkpoint inhibitors and small molecule inhibitors of MEK and BRAF have increased the patient's survival rate but can be burdened with severe side-effects including uveitis. Here, we show the spectrum, treatment, and outcome of uveitis types induced by tumor treatment.
Methods:
In this retrospective study, we have included 54 patients from different centers who were developing uveitis under tumor therapy. A 16-item questionnaire was analyzed for type, treatment, and outcome of uveitis and type of tumor treatment, which we have correlated here.
Results:
Irrespective of the tumor treatment, most patients developed anterior uveitis. All patients received corticosteroids and some additional immunosuppressive treatments. Cessation of tumor therapy was necessary only in a minority of cases.
Conclusions:
Ocular autoimmunity should be differentiated from toxic effects of cancer treatment and timely recognized since it can be generally well controlled by anti-inflammatory treatment, preserving the patient's vision without cessation of the tumor treatment.
Insights
New cancer therapies can cause uveitis, an inflammatory eye condition. Early recognition and anti-inflammatory treatment can preserve vision without stopping cancer treatment.
Area of Science:
- Ophthalmology
- Oncology
- Immunology
Background:
- Cancer therapies like immune checkpoint inhibitors and targeted small molecules improve survival.
- These treatments can cause severe side effects, including uveitis, an inflammation of the eye.
Purpose of the Study:
- To analyze the spectrum, treatment, and outcomes of uveitis induced by cancer therapies.
- To correlate uveitis characteristics with specific tumor treatments.
Main Methods:
- Retrospective study of 54 patients experiencing uveitis during cancer therapy.
- Analysis of a 16-item questionnaire detailing uveitis type, treatment, outcome, and cancer treatment type.
Main Results:
- Anterior uveitis was the most common type, regardless of cancer treatment.
- All patients received corticosteroid treatment, with some requiring additional immunosuppressants.
- Discontinuation of cancer therapy was infrequent.
Conclusions:
- Uveitis associated with cancer treatment is often manageable with anti-inflammatory drugs.
- Timely diagnosis and treatment can preserve vision and allow continuation of cancer therapy.
- Differentiating ocular autoimmunity from treatment toxicity is crucial.
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