Sicca induced by immune checkpoint inhibitors

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but are associated with immune-related adverse events (irAEs), including sicca syndrome. This condition, characterized by ocular and oral dryness, is under-recognized yet significantly impacts patients' quality of life.

This review aims to highlight the prevalence, clinical features, and management strategies for ICI-induced sicca syndrome, emphasizing its distinction from Sjögren disease (SjD) and the importance of early detection and treatment.

Sicca induced by immune checkpoint inhibitors (ICI) is under-estimated but might affect 5 to 24 % of the patients treated by ICI. The pathophysiology of ICI-induced sicca is different from SjD, with infiltration of salivary glands mainly by T lymphocytes. Management of sicca induced by ICI consists of a graded approach, including symptomatic treatment and corticosteroids.

Future research on ICI-induced sicca syndrome should focus on prospective studies to accurately determine its frequency and validate screening tools for early diagnosis. Assessing the benefits of early immunomodulatory treatments and exploring the long-term outcome of the condition are also essential. Understanding the immunological mechanisms and risk factors will be crucial to improve the management. Collaboration among specialists is mandatory to develop comprehensive management guidelines and improving patient condition.