Ipilimumab is a promising novel immunotherapy agent and is associated with a variety of immune-related adverse events (irAEs). The purpose of the study was to investigate the manifestations of irAEs on body imaging in advanced melanoma patients treated with ipilimumab. One-hundred forty-seven advanced melanoma patients (59 women, 88 men, median age:64.5) treated with ipilimumab were studied. All patients had the baseline and at least one follow-up chest/abdomen/pelvis CT or PET/CT during therapy, which were reviewed by a consensus of two radiologists blinded to the clinical data. Findings indicative of individual types of irAEs were assessed, including thyroiditis, sarcoid-like lymphadenopathy, pneumonitis, hepatitis, pancreatitis, and colitis. Among the 147 patients, 46 (31%) had radiologically identified irAEs. Time interval from initiation of therapy to the development of irAEs was less than 3 months in 76% (35/46) of the patients [range:0.2-9.1 months]. Clinical characteristics did not differ between patients with and without irAEs (P>0.18). Among the individual types of irAEs, colitis was most common (n=28;19%), followed by sarcoid-like lymphadenopathy (n=8;5%) and pneumonitis (n=8;5%). Hepatitis (n=3), thyroiditis (n=2), and pancreatitis (n=1) were less common. The resolution of irAEs was noted in 32 among 36 patients (89%) with further follow-up scans, with a median time of 2.3 months after the detection of irAE. In conclusion, immune-related adverse events were noted on body imaging in 31% of melanoma patients treated with ipilimumab. Colitis was most common, followed by sarcoid-like lymphadenopathy and pneumonitis. The results call for increased awareness of irAEs, given the expanding role of cancer immunotherapy.
- Received April 13, 2015.
- Revision received May 7, 2015.
- Accepted June 11, 2015.
- Copyright © 2015, American Association for Cancer Research.