Tampio Alex J F, Dhanireddy Swetha, Sivapiragasam Abirami, Nicholas Brian D
Department of Otolaryngology, 12302SUNY Upstate Medical University, Syracuse, NY, USA.
Department of Ophthalmology, 12302SUNY Upstate Medical University, Syracuse, NY, USA.
Ear Nose Throat J. 2021 Jun;100(3_suppl):286S-291S. doi: 10.1177/0145561320940847. Epub 2020 Jul 23.
Present the case of a 67-year-old male with stage IV malignant melanoma who presented with uveitis and sensorineural hearing loss (SNHL) while on nivolumab and review the literature for likely etiologies.
A retrospective case review was conducted. The current literature was accessed to inquire about possible pathologic mechanisms and treatment options.
A 67-year-old male with stage IV malignant melanoma was treated with nivolumab. During therapy, the patient presented with bilateral uveitis, vertigo, and bilateral moderate sloping to moderate-severe SNHL. After 4 cycles of nivolumab, restaging scans showed no evidence of disease. Nivolumab was discontinued. The patient was placed on a 3-week course of systemic high dose steroids and topical steroid eye drops. Both his uveitis and SNHL resolved after treatment. Nivolumab enhances the antitumor activity of T cells by inhibiting the programed death-1 receptor. While nivolumab has shown great promise in the treatment of many types of cancers, it has also been associated with many autoimmune side effects. We propose the etiology of this 67-year-old male's SNHL and uveitis are the result of an autoimmune process secondary to an augmented T cell response induced by nivolumab.
While immunotherapeutic agents such as nivolumab have shown great promise in the treatment of cancer, one should maintain an awareness and caution of autoimmune side effects such as uveitis and SNHL.
介绍一名67岁IV期恶性黑色素瘤男性患者在接受纳武单抗治疗时出现葡萄膜炎和感音神经性听力损失（SNHL）的病例，并回顾文献以探讨可能的病因。
进行了一项回顾性病例分析。查阅当前文献以探究可能的病理机制和治疗方案。
一名67岁IV期恶性黑色素瘤男性患者接受了纳武单抗治疗。治疗期间，患者出现双侧葡萄膜炎、眩晕以及双侧中度斜坡型至中度重度SNHL。在接受4个周期的纳武单抗治疗后，重新分期扫描显示无疾病证据。纳武单抗停药。患者接受了为期3周的全身高剂量类固醇和局部类固醇眼药水治疗。治疗后其葡萄膜炎和SNHL均得到缓解。纳武单抗通过抑制程序性死亡-1受体增强T细胞的抗肿瘤活性。虽然纳武单抗在治疗多种癌症方面显示出巨大潜力，但它也与许多自身免疫性副作用有关。我们认为这名67岁男性患者的SNHL和葡萄膜炎病因是纳武单抗诱导的T细胞反应增强继发的自身免疫过程。
虽然诸如纳武单抗等免疫治疗药物在癌症治疗中显示出巨大潜力，但应警惕葡萄膜炎和SNHL等自身免疫性副作用。
