Immune Checkpoint Inhibitor-Associated Uveitis: Insights From Comparative Analyses Across Malignancies and Drug Classes.
Melanoma patients on checkpoint inhibitors had much higher uveitis risk than lung cancer patients
Immune Checkpoint Inhibitor-Associated Uveitis: Insights From Comparative Analyses Across Malignancies and Drug Classes.
Understanding how the risk of immune checkpoint inhibitor (immune checkpoint inhibitor)-associated noninfectious uveitis (noninfectious uveitis) differs by malignancy and drug class may help understand its pathophysiology and guide targeted ophthalmic surveillance.
This study aims to evaluate the comparative risk of immune checkpoint inhibitor-associated noninfectious uveitis across different malignancies and drug classes.
Retrospective, multicenter clinical cohort study.
melanoma patients checked far more often for uveitis than lung cancer patients
Excluding ipilimumab/nivolumab, melanoma remained associated with increased risk (0.53% vs 0.16%; RR, 3.40; 95% CI, 1.68-6.88).
Lung cancer showed borderline decreased risk compared to renal cell carcinoma (0.19% vs 0.36%; RR, 0.53; 95% CI, 0.31-0.90), but this effect was not significant after excluding ipilimumab/nivolumab.
In drug-class analyses, anti-PD-1 agents did not demonstrate a significantly different risk of noninfectious uveitis compared with anti-PD-L1 agents (0.26% vs 0.20%; RR, 1.33; 95% CI, 0.89-1.99).
Anti-cytotoxic T-lymphocyte-associated protein 4 agents could not be compared due to limited use as monotherapy.
Both malignancy type and immune checkpoint inhibitor subclass influence the risk of immune checkpoint inhibitor-associated uveitis.
Melanoma carries an intrinsically higher risk independent of ipilimumab/nivolumab exposure, whereas renal cell carcinoma's risk appears largely ipilimumab/nivolumab-driven.
These findings underscore the need for careful monitoring of melanoma patients initiating ICIs and suggest that the pathophysiology of immune checkpoint inhibitor-related uveitis is driven by both drug- and disease-specific factors.