C49-23 Complete Resolution of Pembrolizumab-Induced Sicca Syndrome in a Patient With Metastatic Bladder Cancer: A Case Report

Immune checkpoint inhibitors (ICIs) such as pembrolizumab have revolutionized cancer treatment but can be associated with immune-related adverse events (irAEs). Sicca syndrome is a rare but debilitating irAE that significantly impacts the quality of life. We present the case of a 70-year-old male with a history of metastatic bladder cancer treated with pembrolizumab who developed severe sicca syndrome. The patient initially presented with xerostomia, which progressed to ocular dryness and parotid gland swelling. Despite symptomatic management, symptoms worsened, necessitating treatment cessation and corticosteroid therapy. With prednisone initiation and slow tapering, the patient achieved full resolution of symptoms over 18 months, regaining normal salivary and ocular function while maintaining cancer control despite discontinuation of immunotherapy. Our case highlights the importance of early recognition and management of pembrolizumab-induced sicca syndrome. Prompt cessation of immunotherapy and corticosteroid use can lead to complete symptom resolution, emphasizing the role of vigilant monitoring in patients receiving ICIs. This abstract is funded by: NA