Immune checkpoint inhibitor-induced sarcoidosis-like granulomas

Int J Clin Oncol. 2019 Oct;24(10):1171-1181. doi: 10.1007/s10147-019-01490-2. Epub 2019 Jul 18.

Abstract

Immune checkpoint inhibitors targeting the cytotoxic T lymphocyte-associated antigen-4 and programmed cell death-1 receptors have transformed the treatment of melanoma and other cancers. These therapies are associated with a number of side effects, including immune-related adverse events. Sarcoidosis-like granulomas (SLGs) are important immune checkpoint inhibitor-related reactions to recognize as SLGs can mimic disease progression and accordingly impact treatment decisions. We systematically review reports of immune checkpoint inhibitor-induced SLGs in cancer patients and discuss potential underlying pathophysiological mechanisms.

Keywords: CTLA-4; Drug reactions; Immune checkpoint inhibitor; Melanoma; PD-1; Sarcoidosis-like granuloma.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / adverse effects*
  • CTLA-4 Antigen / antagonists & inhibitors*
  • CTLA-4 Antigen / immunology
  • Cell Cycle Checkpoints / drug effects*
  • Drug-Related Side Effects and Adverse Reactions / etiology*
  • Granuloma / chemically induced*
  • Granuloma / pathology
  • Humans
  • Neoplasms / drug therapy*
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors*
  • Programmed Cell Death 1 Receptor / immunology
  • Sarcoidosis / chemically induced*
  • Sarcoidosis / pathology

Substances

  • Antineoplastic Agents, Immunological
  • CTLA-4 Antigen
  • CTLA4 protein, human
  • Programmed Cell Death 1 Receptor