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Tumor Immunotherapy01:27

Tumor Immunotherapy

Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.

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Immune Checkpoint Inhibitor-Associated Uveitis: Insights From Comparative Analyses Across Malignancies and Drug

Victor Bellanda1, Matthew J Schulgit2, Khaled A Hassan3

  • 1From the Cole Eye Institute (V.B., M.J.S., G.C.S.B., Y.M., N.M., S.K.S., S.S.), Cleveland Clinic, Cleveland, Ohio, USA; Uveitis Center of Excellence (V.B., M.J.S., G.C.S.B., Y.M., N.M., S.K.S., S.S.), Cleveland Clinic, Cleveland, Ohio, USA.

American Journal of Ophthalmology
|June 2, 2026
PubMed
Summary

Melanoma patients have a higher risk of immune checkpoint inhibitor (ICI)-associated non-infectious uveitis (NIU) compared to lung cancer patients. Malignancy type and ICI drug class significantly influence NIU risk.

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Area of Science:

  • Ophthalmology
  • Oncology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) are crucial in cancer therapy.
  • Non-infectious uveitis (NIU) is a known side effect of ICIs.
  • Understanding risk variations by cancer type and drug class is vital for patient management.

Purpose of the Study:

  • To compare the risk of ICI-associated NIU across different malignancies.
  • To evaluate the comparative risk of ICI-associated NIU across different ICI drug classes.
  • To inform targeted ophthalmic surveillance strategies.

Main Methods:

  • Retrospective, multicenter clinical cohort study.
  • Included adult patients with metastatic melanoma, lung cancer, renal cell carcinoma (RCC), urothelial carcinoma, hepatocellular carcinoma, Hodgkin lymphoma, or non-melanoma skin cancer.
  • Propensity score matching was used for demographics, comorbidities, and socioeconomic factors. New-onset NIU within 24 months of first ICI prescription was the primary outcome.

Main Results:

  • Melanoma patients exhibited a significantly higher risk of NIU compared to lung cancer patients (RR, 6.17).
  • This elevated risk in melanoma persisted even after excluding ipilimumab/nivolumab exposure (RR, 3.40).
  • Anti-PD-1 and anti-PD-L1 agents showed similar NIU risks; anti-CTLA-4 could not be compared due to limited monotherapy use.

Conclusions:

  • Malignancy type and ICI drug class are significant factors in ICI-associated uveitis risk.
  • Melanoma has an intrinsic higher risk of NIU, independent of specific ICI agents like ipilimumab/nivolumab.
  • Findings highlight the need for vigilant monitoring in melanoma patients receiving ICIs, suggesting a multifactorial pathophysiology involving both cancer and drug-specific elements.