TY - CHAP
T1 - Immune-Related Oral, Otologic, and Ocular Adverse Events
AU - Srivastava, Akanksha
AU - Al-Zubidi, Nagham
AU - Appelbaum, Eric
AU - Gombos, Dan S.
AU - Nader, Marc Elie
AU - Gidley, Paul W.
AU - Chambers, Mark S.
N1 - Publisher Copyright:
© 2020, Springer Nature Switzerland AG.
PY - 2020
Y1 - 2020
N2 - Emerging immunotherapy agents, such as immune checkpoint inhibitors, have shown remarkable promise in the treatment of various malignancies. These drugs selectively target different steps in the immune response cascade to upregulate the body’s normal response to cancer. Due to the novelty of these therapeutic agents, their toxicity profile is less well understood. Meta-analysis results reveal that the overall prevalence of oral mucositis, stomatitis, and xerostomia is lower with checkpoint inhibitors compared to conventional chemotherapy, and head and neck radiation therapy. However, the widespread use of immunotherapy reveals new oral mucosal barrier adverse events, including bullous pemphigoid, mucous membrane pemphigoid, and lichenoid mucositis. Audiovestibular dysfunction can occur from autoimmune-mediated pathways of immunotherapy (adoptive cell) with limited treatment options. Such auditory complications can lead to speech recognition deficits and sensorineural hearing loss. Ocular toxicities are among the most common adverse events resulting from the use of these agents. The majority of ocular immune-related adverse events (irAEs) are mild, low-grade, non-sight threatening, such as blurred vision, conjunctivitis, and ocular surface disease. Serious and sight-threatening events, including corneal perforation, optic neuropathy, and retinal vascular occlusion, can occur but are infrequent. In this chapter, we review the current evidence on the clinical manifestations of oral, audiovestibular, and ocular immune-related adverse events (i.e., irAEs).
AB - Emerging immunotherapy agents, such as immune checkpoint inhibitors, have shown remarkable promise in the treatment of various malignancies. These drugs selectively target different steps in the immune response cascade to upregulate the body’s normal response to cancer. Due to the novelty of these therapeutic agents, their toxicity profile is less well understood. Meta-analysis results reveal that the overall prevalence of oral mucositis, stomatitis, and xerostomia is lower with checkpoint inhibitors compared to conventional chemotherapy, and head and neck radiation therapy. However, the widespread use of immunotherapy reveals new oral mucosal barrier adverse events, including bullous pemphigoid, mucous membrane pemphigoid, and lichenoid mucositis. Audiovestibular dysfunction can occur from autoimmune-mediated pathways of immunotherapy (adoptive cell) with limited treatment options. Such auditory complications can lead to speech recognition deficits and sensorineural hearing loss. Ocular toxicities are among the most common adverse events resulting from the use of these agents. The majority of ocular immune-related adverse events (irAEs) are mild, low-grade, non-sight threatening, such as blurred vision, conjunctivitis, and ocular surface disease. Serious and sight-threatening events, including corneal perforation, optic neuropathy, and retinal vascular occlusion, can occur but are infrequent. In this chapter, we review the current evidence on the clinical manifestations of oral, audiovestibular, and ocular immune-related adverse events (i.e., irAEs).
KW - Anti-PD-1/PD-L1
KW - Atezolizumab
KW - CTLA-4
KW - Checkpoint inhibitors
KW - Hearing loss
KW - Immune-related ocular toxicities
KW - Immune-related oral toxicities
KW - Immune-related otologic toxicities
KW - Ipilimumab
KW - Nivolumab
KW - Ocular adverse events
KW - Oral adverse events
KW - Pembrolizumab
UR - http://www.scopus.com/inward/record.url?scp=85083631919&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85083631919&partnerID=8YFLogxK
U2 - 10.1007/978-3-030-41008-7_17
DO - 10.1007/978-3-030-41008-7_17
M3 - Chapter
C2 - 32301024
AN - SCOPUS:85083631919
T3 - Advances in Experimental Medicine and Biology
SP - 295
EP - 307
BT - Advances in Experimental Medicine and Biology
PB - Springer
ER -