A Case Report of Drug-Induced Myopathy Involving Extraocular Muscles after Combination Therapy with Tremelimumab and Durvalumab for Non-Small Cell Lung Cancer

Neuro-ophthalmology
William CarreraGregory Kosmorsky

Abstract

Recently developed anti-tumour therapies targeting immune checkpoints include tremelimumab and durvalumab. These agents have incompletely characterised side effect profiles. The authors report a 68-year-old man treated for non-small cell lung cancer (NSCLC) with a combination of tremelimumab and durvalumab. After treatment he developed diplopia, ptosis, fatigue, weakness, and an inflammatory myopathy affecting the extraocular muscles requiring hospitalisation. Electromyography (EMG) testing and muscle biopsy suggested inflammatory myopathy without sign of myasthenia. Within 1 month of withdrawal of cancer therapies and initiation of oral steroid therapy, ocular and systemic symptoms had resolved. This notable adverse effect has not been previously described for these drugs administered singly or in combination, and ophthalmologists should be aware of this presentation in patients treated with these agents.

References

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Citations

Jan 18, 2018·Muscle & Nerve·Noah A KolbMike Hehir
Aug 14, 2020·Expert Opinion on Therapeutic Patents·Nemesio Villa-RuanoMartin Perez-Santos
Aug 30, 2019·Immunotherapy·Carlen YuenKourosh Rezania
Aug 27, 2019·Current Opinion in Ophthalmology·Vivian Paraskevi DouglasDean M Cestari
Nov 12, 2020·Eye and Brain·Caberry W YuJonathan A Micieli
Jan 14, 2021·Survey of Ophthalmology·Carmen Alba-Linero, Emilio Alba
Apr 1, 2021·Drugs·Blake H FortesLauren A Dalvin
Oct 17, 2021·Biochimica Et Biophysica Acta. Reviews on Cancer·Takshveer SinghAli Fatehi Hassanabad
Dec 9, 2021·Pharmaceutical Patent Analyst·Maricruz Anaya-Ruiz, Martin Perez-Santos

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