HLA-DRB1*04:05 in two cases of Vogt-Koyanagi-Harada disease-like uveitis developing from an advanced melanoma patient treated by sequential administration of nivolumab and dabrafenib/trametinib therapy

J Dermatol. 2018 Jun;45(6):735-737. doi: 10.1111/1346-8138.14273. Epub 2018 Feb 27.

Abstract

Although uveitis is reported as a rare adverse event (AE) associated with dabrafenib/trametinib therapy or nivolumab, the occurrence of severe uveitis is extremely rare. We describe two cases of Vogt-Koyanagi-Harada (VKH)-like uveitis developing after the sequential administration of nivolumab and dabrafenib/trametinib therapy. Interestingly, both cases had HLA-DRB1*04:05, which is strongly associated with VKH disease, and achieved biologically complete remission after the treatment for uveitis. Our cases suggest a possible correlation between VKH-like uveitis as an AE and the clinical outcomes of sequential administration of nivolumab and dabrafenib/trametinib therapy for the treatment of advanced melanoma.

Keywords: Vogt-Koyanagi-Harada disease-like uveitis; advanced melanoma; immune-related adverse events; immunotherapy; molecular-targeting therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Choroid / diagnostic imaging
  • Choroid / pathology
  • Female
  • Glucocorticoids / pharmacology
  • Glucocorticoids / therapeutic use
  • HLA-DRB1 Chains / blood*
  • HLA-DRB1 Chains / immunology
  • Humans
  • Imidazoles / adverse effects
  • Magnetic Resonance Imaging
  • Male
  • Melanoma / drug therapy*
  • Nivolumab
  • Oximes / adverse effects
  • Pyridones / adverse effects
  • Pyrimidinones / adverse effects
  • Skin Neoplasms / drug therapy*
  • Treatment Outcome
  • Uveomeningoencephalitic Syndrome / blood
  • Uveomeningoencephalitic Syndrome / chemically induced*
  • Uveomeningoencephalitic Syndrome / drug therapy
  • Uveomeningoencephalitic Syndrome / immunology
  • Visual Acuity / drug effects

Substances

  • Antibodies, Monoclonal
  • Glucocorticoids
  • HLA-DRB1 Chains
  • HLA-DRB1*04 antigen
  • Imidazoles
  • Oximes
  • Pyridones
  • Pyrimidinones
  • Nivolumab
  • trametinib
  • dabrafenib