Diplopia and Acute Vision Loss After Nivolumab Plus Ipilimumab Therapy

摘要

Combination treatment with immune checkpoint [anti-programmed death 1 (PD-1) and anti-cytotoxic T-lymphocyte antigen 4 (CTLA-4) inhibitors] has shown to enhance antitumor activity in front-line and second-line setting in tumors such as metastatic renal clear-cell carcinoma, melanoma, and small-cell lung carcinoma. Upfront treatment with nivolumab plus ipilimumab in de novo metastatic renal clear-cell carcinoma showed improved overall survival and progression-free survival over sunitinib.1 Compared with nivolumab mono-therapy, the nivolumab plus ipilimumab therapy was associated with a significantly higher risk of all- and high-grade immune-related adverse events (ir AEs) such as pruritus, rash, diarrhea, colitis, alanine aminotrans-ferase elevation, and pneumonitis.2 Ocular adverse events with combination therapy are rare and commonly present as uveitis, optic neuritis, hypophysitis, cranial mononeuropathies, or temporal arteritis (Table 1).