Angioedema late in the course of adjuvant nivolumab therapy for melanoma

Abstract

Although immune checkpoint inhibitors improve survival in cancer patients, they have also been linked with unusual side effects. The most common side effects of these agents are immune-mediated phenomena such as itching, skin rash, arthralgias, mild transaminitis and asymptomatic thyroid dysfunction. We describe herein a case of facial angioedema occurring 20 weeks after initiating adjuvant nivolumab therapy for melanoma. The patient had full resolution of symptoms with cessation of nivolumab and a short steroid course. As the causality of an association between nivolumab and angioedema seems legitimate, we expect further similar cases to surface in patients treated with immune checkpoint inhibitors. Prompt drug withdrawal and steroids are crucial to ensure favorable clinical outcomes in these patients.