Nivolumab-induced Vogt-Koyanagi-Harada-like Syndrome and Adrenocortical Insufficiency with Long-term Survival in a Patient with Non-small-cell Lung Cancer

Intern Med. 2021 Nov 15;60(22):3593-3598. doi: 10.2169/internalmedicine.6410-20. Epub 2021 Jun 5.

Abstract

A 58-year-old man was diagnosed with lung adenocarcinoma with a tumor proportion score of 10%. After six cycles of second-line chemotherapy with nivolumab, he achieved a complete response (CR) but developed uveitis and sensorineural hearing disorder, which were consistent with Vogt-Koyanagi-Harada (VKH)-like syndrome. Simultaneously, pituitary adrenocortical insufficiency was identified. Nivolumab discontinuation and systemic corticosteroid administration resolved these immune-related adverse events (irAEs). The patient has maintained a CR without any chemotherapy for approximately two years. We herein report a patient with a long-term progression-free survival despite chemotherapy discontinuation due to irAEs, including VKH-like syndrome, which were appropriately managed.

Keywords: HLA-DR4; Vogt-Koyanagi-Harada-like syndrome; adrenocortical insufficiency; immune-related adverse events; non-small-cell lung cancer.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Humans
  • Lung Neoplasms* / drug therapy
  • Male
  • Middle Aged
  • Nivolumab / adverse effects
  • Uveitis*
  • Uveomeningoencephalitic Syndrome* / chemically induced
  • Uveomeningoencephalitic Syndrome* / diagnosis
  • Uveomeningoencephalitic Syndrome* / drug therapy

Substances

  • Nivolumab