Sicca induced by immune checkpoint inhibitors

Area of Science:

• Oncology
• Immunology
• Rheumatology

Background:

• Immune checkpoint inhibitors (ICIs) have transformed cancer therapy.
• Immune-related adverse events (irAEs) are common with ICIs, including sicca syndrome (ocular/oral dryness).
• ICI-induced sicca syndrome is under-recognized and impacts patient quality of life.

Purpose of the Study:

• Review prevalence, clinical features, and management of ICI-induced sicca syndrome.
• Differentiate ICI-induced sicca from Sjögren disease (SjD).
• Emphasize early detection and treatment strategies.

Main Methods:

• Literature review focusing on ICI-induced sicca syndrome.
• Analysis of prevalence, clinical presentation, and pathophysiology.
• Evaluation of current and proposed management strategies.

Main Results:

• ICI-induced sicca affects an estimated 5-24% of patients.
• Pathophysiology involves T-lymphocyte infiltration of salivary glands, differing from SjD.
• Management includes symptomatic relief and corticosteroids.

Conclusions:

• ICI-induced sicca is a significant irAE requiring attention.
• Further research needed on frequency, screening, early treatments, and long-term outcomes.
• Multidisciplinary collaboration is essential for guideline development and improved patient care.