Checkpoint inhibitor induced esophagitis with documented resolution on infliximab

Abstract

Gastrointestinal toxicity is a leading adverse event from the use of cancer immunotherapy. Prompt recognition and treatment are integral to improving clinical outcomes in patients with these complications. While upper gastrointestinal involvement such as gastritis and duodenitis has been increasingly recognized with the use of immune checkpoint inhibitors (ICIs), there have been few reported cases of esophageal involvement and none to our knowledge that have resolved with anti-tumor necrosis factor alpha therapy. Here, we discuss the management of a 75 year-old woman with metastatic melanoma who was treated with nivolumab and developed ICI induced esophageal toxicity 5 weeks after her first treatment. She was initially unsuccessfully treated with steroids followed by three doses of infliximab which resulted in resolution of the esophagitis.

Keywords

• Immune checkpoint inhibitors
• Esophagitis
• Infliximab
• Toxicity
• Immune related adverse event