Sudden Otovestibular Dysfunction in 3 Metastatic Melanoma Patients Treated With Immune Checkpoint Inhibitors

J Immunother. 2021 Jun 1;44(5):193-197. doi: 10.1097/CJI.0000000000000367.

Abstract

Immune-related adverse events have been described in 86%-96% of high-risk melanoma patients treated with immune checkpoint inhibitors (ICI), while in 17%-59% of cases these are classified as severe or even life-threatening. The most common immune-related adverse events include diarrhea, fatigue, hypothyroidism, and hepatitis. Bilateral uveitis and unspecific vertigo have been described in 1% of cases, respectively, in the pivotal studies of ICIs, but the affection of the vestibule-cochlear system has not been reported before. In this case series, we present 3-stage IV melanoma patients with sudden onset of otovestibular dysfunction (hearing loss and vestibulopathy), partly combined with uveitis because of ICIs. We describe detailed diagnostic work-up and therapeutic interventions and discuss possible pathogenic mechanisms of this rare and disabling event.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cochlear Diseases / diagnosis
  • Cochlear Diseases / etiology
  • Female
  • Hearing Tests
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Immune Checkpoint Inhibitors / therapeutic use
  • Male
  • Melanoma / complications*
  • Melanoma / diagnosis
  • Melanoma / drug therapy
  • Middle Aged
  • Molecular Targeted Therapy / adverse effects
  • Molecular Targeted Therapy / methods
  • Ototoxicity / diagnosis*
  • Ototoxicity / etiology*
  • Symptom Assessment
  • Tomography, X-Ray Computed
  • Vestibular Diseases / diagnosis*
  • Vestibular Diseases / etiology*

Substances

  • Immune Checkpoint Inhibitors