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Abstract

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Article in Japanese

Case Report

Bilateral panuveitis induced by nivolumab in a patient with non-small cell lung cancer on hemodialysis

Yuki Ueharaa  Konomi Kobayashia  Yuki Suzukia  Kazuma Kitsub  Atsushi Mizotab  Hiroyuki Nagasea 

aDivision of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine
bDepartment of Ophthalmology, Teikyo University School of Medicine

ABSTRACT

An 83-year-old man on hemodialysis was diagnosed with unresectable squamous cell lung cancer (clinical stage IIIB, T1cN3M0) that disqualified him from concomitant chemoradiotherapy. Nivolumab was administered as second line chemotherapy after disease progression following two cycles of combination therapy of carboplatin and paclitaxel. After six cycles of nivolumab treatment, the patient complained of poor vision. The diagnosis was bilateral panuveitis accompanied by retinal detachment in the right eye. Nivolumab was re-administered on improvement in the inflammation achieved by topical corticosteroid. However, retinal detachment recurred in 2 weeks, requiring sub-Tenon triamcinolone actinide injection. The patient’s vision improved only by topical treatments. Despite the discontinuance of nivolumab and without other additional anti-cancer therapy, the patient has maintained a stable disease status for 9 months. Although immune checkpoint-induced uveitis is rare in non-small cell lung cancer, respiratory physicians should be aware of possible ocular complications associated with immune checkpoint inhibitors, especially with those targeting CTLA-4, as they have a higher risk of developing uveitis than PD-1/PD-L1 inhibitors.

KEYWORDS

Nivolumab  Uveitis  Immune-related adverse event (irAE)  Lung cancer 

Received 31 Mar 2021 / Accepted 10 Aug 2021

AJRS, 10(6): 463-467, 2021

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