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免疫检查点抑制剂治疗的 3 例转移性黑色素瘤患者突发前庭耳蜗功能障碍

Sudden Otovestibular Dysfunction in 3 Metastatic Melanoma Patients Treated With Immune Checkpoint Inhibitors.

机构信息

Department of Dermatology and Allergy, University Hospital.

Department of Otorhinolaryngology, Head and Neck Surgery, Großhadern Medical Center, Ludwig-Maximilians University, Munich.

出版信息

J Immunother. 2021 Jun 1;44(5):193-197. doi: 10.1097/CJI.0000000000000367.


DOI:10.1097/CJI.0000000000000367
PMID:33734141
Abstract

Immune-related adverse events have been described in 86%-96% of high-risk melanoma patients treated with immune checkpoint inhibitors (ICI), while in 17%-59% of cases these are classified as severe or even life-threatening. The most common immune-related adverse events include diarrhea, fatigue, hypothyroidism, and hepatitis. Bilateral uveitis and unspecific vertigo have been described in 1% of cases, respectively, in the pivotal studies of ICIs, but the affection of the vestibule-cochlear system has not been reported before. In this case series, we present 3-stage IV melanoma patients with sudden onset of otovestibular dysfunction (hearing loss and vestibulopathy), partly combined with uveitis because of ICIs. We describe detailed diagnostic work-up and therapeutic interventions and discuss possible pathogenic mechanisms of this rare and disabling event.

摘要

免疫相关不良反应在接受免疫检查点抑制剂 (ICI) 治疗的高危黑色素瘤患者中已有 86%-96%的描述,而在 17%-59%的病例中这些不良反应被归类为严重甚至危及生命。最常见的免疫相关不良反应包括腹泻、疲劳、甲状腺功能减退和肝炎。在 ICI 的关键研究中,分别有 1%的病例出现双侧葡萄膜炎和非特异性眩晕,但前庭耳蜗系统的受累以前没有报道过。在本病例系列中,我们报告了 3 例 IV 期黑色素瘤患者,由于 ICI 导致突发性耳前庭功能障碍(听力损失和前庭病),部分伴有葡萄膜炎。我们描述了详细的诊断方法和治疗干预措施,并讨论了这种罕见且致残事件的可能发病机制。

相似文献

[1]
Sudden Otovestibular Dysfunction in 3 Metastatic Melanoma Patients Treated With Immune Checkpoint Inhibitors.

J Immunother. 2021-6-1

[2]
Immune-mediated ototoxicity associated with immune checkpoint inhibitors in patients with melanoma.

J Immunother Cancer. 2020-12

[3]
Encephalitis Associated With Immune Checkpoint Inhibitor Treatment in Patients With Melanoma.

J Immunother. 2021-6-1

[4]
Primary Biliary Cirrhosis and Granulomatous Hepatitis After Immune Checkpoint Blockade in Patients With Metastatic Melanoma: Report of 2 Cases and Literature Discussion.

J Immunother.

[5]
Risk Factors for Relapse after Intentional Discontinuation of Immune Checkpoint Inhibitors in Melanoma Patients.

J Immunother.

[6]
The association between immune checkpoint or BRAF/MEK inhibitor therapy and uveitis in patients with advanced cutaneous melanoma.

Eur J Cancer. 2021-2

[7]
Ototoxicity in Immune Checkpoint Inhibitors Therapy.

Otolaryngol Pol. 2024-6-30

[8]
Outcomes after resumption of immune checkpoint inhibitor therapy after high-grade immune-mediated hepatitis.

Cancer. 2020-12-1

[9]
Permanent unilateral vestibulocochlear dysfunction after spinal anesthesia.

Anesth Analg. 1996-2

[10]
Population-Based Frequency of Ophthalmic Adverse Events in Melanoma, Other Cancers, and After Immune Checkpoint Inhibitor Treatment.

Am J Ophthalmol. 2021-4

引用本文的文献

[1]
Immune checkpoint inhibitor-associated Vogt-Koyanagi-Harada-like syndrome: A descriptive systematic review.

J Ophthalmic Inflamm Infect. 2025-5-12

[2]
The Impact of Monoclonal Antibody Usage on Hearing Outcomes: A Systematic Review.

Laryngoscope. 2025-2

[3]
Diagnosing and Managing Uveitis Associated with Immune Checkpoint Inhibitors: A Review.

Diagnostics (Basel). 2024-2-4

[4]
Immune checkpoint inhibitor-related hearing loss: a systematic review and analysis of individual patient data.

Support Care Cancer. 2023-10-11

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