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irAEs — SCE Medical Oncology MCQ

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ModerateImmunotherapy & Targeted TherapyirAEsSCE Medical Oncology

A 55-year-old woman on nivolumab for metastatic melanoma develops acute visual loss in the right eye. Ophthalmological examination reveals anterior uveitis with keratic precipitates. What is the most appropriate management?

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Correct answer: A — Topical corticosteroid eye drops and ophthalmology follow-up; hold nivolumab

Immune-related uveitis is managed primarily with topical corticosteroid eye drops (and mydriatics) for grade 1-2 disease, with ophthalmology involvement. ICI should be held for grade 2+ uveitis and can be cautiously resumed after resolution. Systemic corticosteroids are reserved for posterior uveitis, severe bilateral disease, or corticosteroid-refractory cases. Permanent ICI discontinuation is recommended for grade 4 ocular toxicity or vision-threatening inflammation.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer