Managing Pancreatic Injury from Immune Checkpoint Inhibitors

A retrospective study across eight Austrian and Swiss dermatology centers has highlighted the high frequency of pancreatic enzyme elevation in melanoma patients treated with immune checkpoint inhibitors (ICI). Among 1516 patients, 204 exhibited significant lipase elevation, with 41 developing symptoms of pancreatitis. Although radiographic signs of pancreatitis were rare in asymptomatic cases, nearly half of patients with elevated lipase levels had their immunotherapy interrupted or discontinued, and 50% were treated with systemic corticosteroids. The study calls for an updated management approach, suggesting lipase monitoring be reserved for symptomatic patients or those with radiographic evidence of pancreatic injury, and presents a diagnostic and therapeutic algorithm to better address immune checkpoint inhibitor-induced pancreatic injury (ICIPI).