Uveitis may be a side effect of some biologic cancer therapies

Researchers in Israel used patient chart data to study the effect of biologic treatments for cancer on uveitis onset.

Study design

This was a retrospective case cohort study of 6 patients aged 14–81 years. All patients had uveitis induced by treatment with either vemurafenib, nivolumab, ipilimumab, or osimertinib. The cancer subtypes diagnosed in the patients were metastatic thyroid carcinoma, pleomorphic xanthoastrocytoma, metastatic melanoma, adenocarcinoma of the lung, and metastatic breast cancer.

Outcomes

Uveitis was bilateral in 4 patients and unilateral in 2 patients, with manifestation seen 4–82 weeks after treatment was initiated. The median duration of uveitis was 70 weeks (range 8–150 weeks). Patients exhibited bilateral asymmetric or symmetric anterior uveitis, unilateral intermediate uveitis with or without anterior uveitis, and bilateral anterior and intermediate uveitis. Macular edema was noted in 1 patient. Uveitis treatment included topical steroids alone or combined with systemic glucocorticoids, or with a single unilateral intravitreal glucocorticoid injection. Biologic therapy was interrupted for only 1 patient, and then for just 10 days.

Limitations

The retrospective design and relatively small sample size are possible study limitations.

Clinical significance

Specific questions about treatment with biologic agents for cancer should be asked of patients with uveitis, as early detection can potentially stave off ocular complications. Existing recommendations suggest pausing these treatments, or even permanently discontinuing them in severe cases such as panuveitis.