Anterior Uveitis Secondary to Avelumab and Pembrolizumab in a Patient with Metastatic Renal Cell Carcinoma—A Case Report
We present an unusual case of uveitis secondary to avelumab and pembrolizumab in a 39-year-old Taiwanese male with stage IV clear cell renal cell carcinoma (ccRCC) and lung metastasis, who initially received pembrolizumab as his primary treatment. However, the patient experienced skin and liver immu...
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MDPI AG
2024-03-01
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| Online Access: | https://www.mdpi.com/2571-841X/7/1/19 |
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| author | Wei-Lun Chu Kai-Chun Cheng Pei-Kang Liu Hung-Chi Lai Kuo-Jen Chen Yo-Chen Chang |
| author_facet | Wei-Lun Chu Kai-Chun Cheng Pei-Kang Liu Hung-Chi Lai Kuo-Jen Chen Yo-Chen Chang |
| author_sort | Wei-Lun Chu |
| collection | DOAJ |
| description | We present an unusual case of uveitis secondary to avelumab and pembrolizumab in a 39-year-old Taiwanese male with stage IV clear cell renal cell carcinoma (ccRCC) and lung metastasis, who initially received pembrolizumab as his primary treatment. However, the patient experienced skin and liver immune-related adverse events (irAEs) after the seventh dose of pembrolizumab, which prompted a switch to avelumab. The patient began to experience gradual blurring of vision after completing the fifth cycle of avelumab immunotherapy. Ophthalmic examinations revealed findings consistent with bilateral anterior uveitis. Despite an initial lack of significant improvement with steroid treatment, the patient’s vision and inflammation improved upon discontinuation of avelumab. Due to the occurrence of uveitis, avelumab was switched back to pembrolizumab. However, three months after initiating pembrolizumab, the patient developed foggy vision and bilateral anterior uveitis with cystoid macular edema (CME). The administration of topical, oral, and subconjunctival steroids resulted in an improvement in vision and the resolution of CME, without the need to discontinue pembrolizumab. Over the subsequent eighteen months, there has been no recurrence of uveitis, and there is no evidence of relapse or further metastasis in his ccRCC. |
| first_indexed | 2024-04-24T17:51:20Z |
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| id | doaj.art-18e6ef8398494f749a6e469db09704d9 |
| institution | Directory Open Access Journal |
| issn | 2571-841X |
| language | English |
| last_indexed | 2024-04-24T17:51:20Z |
| publishDate | 2024-03-01 |
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| record_format | Article |
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| spelling | doaj.art-18e6ef8398494f749a6e469db09704d92024-03-27T14:02:58ZengMDPI AGReports2571-841X2024-03-01711910.3390/reports7010019Anterior Uveitis Secondary to Avelumab and Pembrolizumab in a Patient with Metastatic Renal Cell Carcinoma—A Case ReportWei-Lun Chu0Kai-Chun Cheng1Pei-Kang Liu2Hung-Chi Lai3Kuo-Jen Chen4Yo-Chen Chang5Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, TaiwanDepartment of Ophthalmology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 812, TaiwanDepartment of Ophthalmology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 812, TaiwanDepartment of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung 807, TaiwanDepartment of Ophthalmology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 812, TaiwanDepartment of Ophthalmology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 812, TaiwanWe present an unusual case of uveitis secondary to avelumab and pembrolizumab in a 39-year-old Taiwanese male with stage IV clear cell renal cell carcinoma (ccRCC) and lung metastasis, who initially received pembrolizumab as his primary treatment. However, the patient experienced skin and liver immune-related adverse events (irAEs) after the seventh dose of pembrolizumab, which prompted a switch to avelumab. The patient began to experience gradual blurring of vision after completing the fifth cycle of avelumab immunotherapy. Ophthalmic examinations revealed findings consistent with bilateral anterior uveitis. Despite an initial lack of significant improvement with steroid treatment, the patient’s vision and inflammation improved upon discontinuation of avelumab. Due to the occurrence of uveitis, avelumab was switched back to pembrolizumab. However, three months after initiating pembrolizumab, the patient developed foggy vision and bilateral anterior uveitis with cystoid macular edema (CME). The administration of topical, oral, and subconjunctival steroids resulted in an improvement in vision and the resolution of CME, without the need to discontinue pembrolizumab. Over the subsequent eighteen months, there has been no recurrence of uveitis, and there is no evidence of relapse or further metastasis in his ccRCC.https://www.mdpi.com/2571-841X/7/1/19case reportuveitisimmune checkpoint inhibitoravelumabpembrolizumab |
| spellingShingle | Wei-Lun Chu Kai-Chun Cheng Pei-Kang Liu Hung-Chi Lai Kuo-Jen Chen Yo-Chen Chang Anterior Uveitis Secondary to Avelumab and Pembrolizumab in a Patient with Metastatic Renal Cell Carcinoma—A Case Report Reports case report uveitis immune checkpoint inhibitor avelumab pembrolizumab |
| title | Anterior Uveitis Secondary to Avelumab and Pembrolizumab in a Patient with Metastatic Renal Cell Carcinoma—A Case Report |
| title_full | Anterior Uveitis Secondary to Avelumab and Pembrolizumab in a Patient with Metastatic Renal Cell Carcinoma—A Case Report |
| title_fullStr | Anterior Uveitis Secondary to Avelumab and Pembrolizumab in a Patient with Metastatic Renal Cell Carcinoma—A Case Report |
| title_full_unstemmed | Anterior Uveitis Secondary to Avelumab and Pembrolizumab in a Patient with Metastatic Renal Cell Carcinoma—A Case Report |
| title_short | Anterior Uveitis Secondary to Avelumab and Pembrolizumab in a Patient with Metastatic Renal Cell Carcinoma—A Case Report |
| title_sort | anterior uveitis secondary to avelumab and pembrolizumab in a patient with metastatic renal cell carcinoma a case report |
| topic | case report uveitis immune checkpoint inhibitor avelumab pembrolizumab |
| url | https://www.mdpi.com/2571-841X/7/1/19 |
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