Recurrent audiovestibular dysfunction and associated neurological immune‐related adverse events in a melanoma patient treated with nivolumab and ipilimumab

• DOI: 10.1002/hed.26455
• Publication Date: 2020-09-05T08:06:41Z
• Authors: Jonathan S. Choi; Merry Chen; Jennifer L. McQuade; Eric Appelbaum; Paul W. Gidley; Marc‐Elie Nader
• Keywords: Ototoxicity; Discontinuation; Audiogram

Abstract Background Recurrent immunotherapy‐induced audiovestibular toxicity despite cessation of therapy has not been reported. Methods We report the first case recurrent following immune‐checkpoint inhibitor (ICI) therapy. The patient was seen with sudden bilateral hearing loss and disequilibrium. After ruling out other etiologies, he diagnosed neurological immune‐related adverse events (irAEs). He received systemic steroids, significant balance recovery. Over 4 months, experienced two episodes ICIs cessation. second episode treated oral improved. On third episode, intratympanic started on infliximab. Results Audiogram 8 months last recurrence showed improvement stability. Conclusion Immunotherapy‐induced ototoxicity may recur High dose steroids remain mainstay treatment. If irAEs multiple courses immunosuppressive agents be considered.