Posterior-scleritis: Case report of an uncommon immune-related adverse event in the treatment of advanced endometrial cancer
As Immune checkpoint inhibitors are being expanded for use in gynecologic malignancies, rare immune-related adverse events are more frequently being reported. Here we describe a 63-year-old with Stage IIIB mismatch repair deficient uterine adenocarcinoma who underwent six cycles of carboplatin and p...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Gynecologic Oncology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578923003132 |
| _version_ | 1797390461846945792 |
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| author | Brandon I. Ing Derek Kuhl Deanna Glassman Cynae A. Johnson Shrina Patel Amir A. Jazaeri |
| author_facet | Brandon I. Ing Derek Kuhl Deanna Glassman Cynae A. Johnson Shrina Patel Amir A. Jazaeri |
| author_sort | Brandon I. Ing |
| collection | DOAJ |
| description | As Immune checkpoint inhibitors are being expanded for use in gynecologic malignancies, rare immune-related adverse events are more frequently being reported. Here we describe a 63-year-old with Stage IIIB mismatch repair deficient uterine adenocarcinoma who underwent six cycles of carboplatin and paclitaxel with partial response but persistent disease. She was then started on single agent pembrolizumab. After six cycles of pembrolizumab, she developed bilateral vision changes and was diagnosed with posterior scleritis. Pembrolizumab was held and she was treated with oral prednisone, with rapid resolution of symptoms. One month after completion of prednisone, vision changes were again reported and she was restarted on a longer oral prednisone course. She then underwent definitive surgical management consisting of a total laparoscopic hysterectomy and bilateral salpingo-oophorectomy, with final pathology of benign endometrial hyperplasia. She has completed her steroid course without any symptoms. Given her complete pathologic response, she was subsequently placed into surveillance and is currently without evidence of disease. Prompt recognition and treatment of this rare immune-related adverse event led to the prevention of potential permanent, debilitating outcomes. |
| first_indexed | 2024-03-08T23:11:08Z |
| format | Article |
| id | doaj.art-1d8c92e7e3784f97af22a23aa7f9fe6e |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-03-08T23:11:08Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-1d8c92e7e3784f97af22a23aa7f9fe6e2023-12-15T07:24:49ZengElsevierGynecologic Oncology Reports2352-57892023-12-0150101296Posterior-scleritis: Case report of an uncommon immune-related adverse event in the treatment of advanced endometrial cancerBrandon I. Ing0Derek Kuhl1Deanna Glassman2Cynae A. Johnson3Shrina Patel4Amir A. Jazaeri5University of Texas MD Anderson Cancer Center, Division of Gynecologic Oncology and Reproductive Medicine Unit 1362, P.O. Box 301439, Houston, TX 77230, United States; Corresponding author at: Present address: 4900 Sunset Blvd, 5th Floor, Los Angeles, CA 90027, United States.The Retina Center, 2806 E 29th Street, Bryan TX 77802, United StatesUniversity of Texas MD Anderson Cancer Center, Division of Gynecologic Oncology and Reproductive Medicine Unit 1362, P.O. Box 301439, Houston, TX 77230, United StatesUniversity of Texas MD Anderson Cancer Center, Division of Gynecologic Oncology and Reproductive Medicine Unit 1362, P.O. Box 301439, Houston, TX 77230, United StatesUniversity of Texas MD Anderson Cancer Center, Division of Gynecologic Oncology and Reproductive Medicine Unit 1362, P.O. Box 301439, Houston, TX 77230, United StatesUniversity of Texas MD Anderson Cancer Center, Division of Gynecologic Oncology and Reproductive Medicine Unit 1362, P.O. Box 301439, Houston, TX 77230, United StatesAs Immune checkpoint inhibitors are being expanded for use in gynecologic malignancies, rare immune-related adverse events are more frequently being reported. Here we describe a 63-year-old with Stage IIIB mismatch repair deficient uterine adenocarcinoma who underwent six cycles of carboplatin and paclitaxel with partial response but persistent disease. She was then started on single agent pembrolizumab. After six cycles of pembrolizumab, she developed bilateral vision changes and was diagnosed with posterior scleritis. Pembrolizumab was held and she was treated with oral prednisone, with rapid resolution of symptoms. One month after completion of prednisone, vision changes were again reported and she was restarted on a longer oral prednisone course. She then underwent definitive surgical management consisting of a total laparoscopic hysterectomy and bilateral salpingo-oophorectomy, with final pathology of benign endometrial hyperplasia. She has completed her steroid course without any symptoms. Given her complete pathologic response, she was subsequently placed into surveillance and is currently without evidence of disease. Prompt recognition and treatment of this rare immune-related adverse event led to the prevention of potential permanent, debilitating outcomes.http://www.sciencedirect.com/science/article/pii/S2352578923003132PembrolizumabImmune-relatedEndometrial cancerImmunotherapy toxicityImmune checkpoint inhibitor |
| spellingShingle | Brandon I. Ing Derek Kuhl Deanna Glassman Cynae A. Johnson Shrina Patel Amir A. Jazaeri Posterior-scleritis: Case report of an uncommon immune-related adverse event in the treatment of advanced endometrial cancer Gynecologic Oncology Reports Pembrolizumab Immune-related Endometrial cancer Immunotherapy toxicity Immune checkpoint inhibitor |
| title | Posterior-scleritis: Case report of an uncommon immune-related adverse event in the treatment of advanced endometrial cancer |
| title_full | Posterior-scleritis: Case report of an uncommon immune-related adverse event in the treatment of advanced endometrial cancer |
| title_fullStr | Posterior-scleritis: Case report of an uncommon immune-related adverse event in the treatment of advanced endometrial cancer |
| title_full_unstemmed | Posterior-scleritis: Case report of an uncommon immune-related adverse event in the treatment of advanced endometrial cancer |
| title_short | Posterior-scleritis: Case report of an uncommon immune-related adverse event in the treatment of advanced endometrial cancer |
| title_sort | posterior scleritis case report of an uncommon immune related adverse event in the treatment of advanced endometrial cancer |
| topic | Pembrolizumab Immune-related Endometrial cancer Immunotherapy toxicity Immune checkpoint inhibitor |
| url | http://www.sciencedirect.com/science/article/pii/S2352578923003132 |
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