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Sicca induced by immune checkpoint inhibitors.

Rakiba Belkhir1, Marjolaine Gosset2, Antoine Rousseau3

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Immune checkpoint inhibitors (ICIs) can cause sicca syndrome, affecting 5-24% of patients. Early detection and management, distinct from Sjögren disease, are crucial for improving patient quality of life.

Keywords:
DrynessImmune checkpoint inhibitorsImmune-related adverse eventsSiccaSjögren disease

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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.