Uveitis secondary to cancer therapeutics
作者机构：Cole Eye InstituteCleveland ClinicClevelandOHUSA
出 版 物：《Annals of Eye Science》 (眼科学年鉴（英文）)
年 卷 期：2020年第5卷第2期
页 面：95-100页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Immunotherapy uveitis checkpoint inhibitors targeted therapy
摘 要：Cancer cells provide a therapeutic challenge as they impede the immune system and its response to *** inhibitors and targeted therapy provide novel methods for the treatment of these *** use of immunotherapy and targeted therapy is widespread,with indications including metastatic melanoma,squamous cell carcinoma,non-small cell lung cancer,colon cancer,gastric cancer,renal cell carcinoma,Merkel cell carcinoma and urothelial *** inhibitors act upon three main receptors or ligands to achieve this goal:cytotoxic T-lymphocyte antigen-4(CTLA-4),programmed death protein(PD-1)and programmed death ligand-1(PD-L1).Additionally,targeted therapies counter the mutations leading to cancer cell proliferation,which include the mitogen-activated protein kinase(MEK)pathway and BRAF ***,they are known to cause ocular side effects in up to 1%of patients,with uveitis comprising a fraction of these *** secondary uveitis manifestations can present with severity ranging from solitary anterior uveitis to panuveitis,sometimes in concert with systemic manifestations such as Vogt-Koyanagi-Harada(VKH)-like *** uveitis caused by these medications can present both diagnostic and treatment challenges that can complicate patient *** steroids have demonstrated mixed data regarding the reduction of cancer therapeutic efficacy,and as a result,immunotherapy and targeted therapy are often held when systemic steroids are used for immune-related adverse event(irAE)*** steroids,although prone to their own set of adverse effects,may therefore be preferable to systemic steroids in the treatment of uveitis secondary to cancer *** this review,we provide an overview of uveitis secondary to targeted therapy and immunotherapy,as well as treatment considerations.
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