These are tough situations with patients receiving adjuvant treatment. Just a few questions, has treatment been with held at all to allow time for resolution? What is the patients level of motivation to continue in light of this persistent irAE which is impacting QOL? Was Sjogren’s considered or investigated with labs?
So taking inventory that:
This irAE being one of the less common one but it is no less impactful that other irAE’s & we don’t know potential long term issues ( ie dental issues)
It can be difficult to treat and and have prolonged resolution
The pt is almost half finished with therapy
My thoughts are; this is adjuvant I would hold treatment allow all toxicity to resolve, let the patient regain the lost weight if appropriate and see if patient can be restarted on therapy to complete a 12 month course of therapy successfully.
Thanks for bringing this challenging case for discussion, Looking forward to your reply!