Orofacial complications from immune checkpoint inhibitors: A retrospective analysis from two academic medical centers

Background Immune checkpoint inhibitors (ICIs) are FDA‐approved for various cancers, yet their orofacial immune‐related adverse events (irAEs) remain poorly understood. Our two‐center retrospective study aims to better understand the prevalence and nature of these orofacial irAEs. Methods We retrospectively collected demographics, ICI details, and onset of orofacial irAEs in ICI‐treated patients at University of California San Francisco and City of Hope (2013–2021). Orofacial irAEs were identified by ICD‐10 codes and data categorized as dry mouth/xerostomia, oral mucosal lesions, and orofacial neuropathies. Patients with pre‐existing orofacial conditions resembling the reported irAEs were excluded. Results Among 3768 ICI‐treated patients, 408 (10.8%) developed 467 orofacial irAEs: oral mucosal diseases (41.4%), dry mouth/xerostomia (41.0%), and orofacial neuropathies (17.6%). Notably, head and neck cancers had the highest incidence of orofacial irAEs. Conclusions Orofacial irAEs are relatively common in patients receiving ICIs, necessitating careful monitoring and management of these complications during and after the treatment.