Cancer and autoimmune diseases

Giat, Eitan; Ehrenfeld, Michael; Shoenfeld, Yehuda

doi:10.1016/j.autrev.2017.07.022

Cited by 158 publications

(113 citation statements)

References 104 publications

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“…As previously mentioned, auto‐immunity and cancer are closely linked; there is surely a direct proportionality between chronic inflammation and cancer , but it is a “two‐way” relationship. Indeed, although AIDs lead to an increased risk of developing cancer, cancer itself is a condition that increases the risk of developing AIDs . We focused our attention on patients with pre‐existing AIDs, finding an overall incidence of 11.3% among our “real‐life” population.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Patients with Advanced Cancer and Pre-Existing Autoimmune Diseases Treated with Anti-Programmed Death-1 Immunotherapy: A Real-World Transverse Study

et al. 2019

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Background Patients with a history of autoimmune diseases (AIDs) have not usually been included in clinical trials with immune checkpoint inhibitors. Materials and Methods Consecutive patients with advanced cancer, treated with anti‐programmed death‐1 (PD‐1) agents, were evaluated according to the presence of pre‐existing AIDs. The incidence of immune‐related adverse events (irAEs) and clinical outcomes were compared among subgroups. Results A total of 751 patients were enrolled; median age was 69 years. Primary tumors were as follows: non‐small cell lung cancer, 492 (65.5%); melanoma, 159 (21.2%); kidney cancer, 94 (12.5%); and others, 6 (0.8%). Male/female ratio was 499/252. Eighty‐five patients (11.3%) had pre‐existing AIDs, further differentiated in clinically active (17.6%) and inactive (82.4%). Among patients with pre‐existing AIDs, incidence of irAEs of any grade was significantly higher when compared with patients without AIDs (65.9% vs. 39.9%). At multivariate analysis, both inactive (p = .0005) and active pre‐existing AIDs (p = .0162), female sex (p = .0004), and Eastern Cooperative Oncology Group Performance Status <2 (p = .0030) were significantly related to a higher incidence of irAEs of any grade. No significant differences were observed regarding grade 3/4 irAEs and objective response rate among subgroups. Pre‐existing AIDs were not significantly related with progression‐free survival and overall survival. Conclusion This study quantifies the increased risk of developing irAEs in patients with pre‐existing AIDs who had to be treated with anti‐PD‐1 immunotherapy. Nevertheless, the incidence of grade 3/4 irAEs is not significantly higher when compared with control population. The finding of a greater incidence of irAEs among female patients ranks among the “hot topics” in gender‐related differences in immuno‐oncology. Implications for Practice Patients with a history of autoimmune diseases (AIDs) have not usually been included in clinical trials with immune checkpoint inhibitors but are frequent in clinical practice. This study quantifies the increased risk of developing immune‐related adverse events (irAEs) in patients with pre‐existing AIDs who had to be treated with anti‐programmed death‐1 immunotherapy. Nevertheless, their toxicities are mild and the incidence of grade 3/4 irAEs is not significantly higher compared with those of controls. These results will help clinicians in everyday practice, improving their ability to offer a proper counselling to patients, in order to offer an immunotherapy treatment even to patients with pre‐existing autoimmune disease.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Patients with Advanced Cancer and Pre-Existing Autoimmune Diseases Treated with Anti-Programmed Death-1 Immunotherapy: A Real-World Transverse Study

et al. 2019

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“…Hormonal factors also have been included among events triggering autoimmunity or immune dysfunction. This combined fact highlights the involvement between autoimmunity and cancer [36,37]. This fi eld of study reveals that there are autoantibodies in the plasma of patient with breast cancer that interrelate with Bovine serum albumin.…”

Section: Disussionmentioning

confidence: 88%

Evaluation of breast cancer regarding molecular and immunochemical markers

Sabra¹,

Saad²,

Moneim³

et al. 2020

Int J Immunother Cancer Res

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Early-stage cancer recognition could improve awareness and treatment strategies. Twenty four breast cancer affected individuals had their DNA isolated from malignant tissues and from blood. DNA was then amplifi ed by RAPD with six different ten-mer primers. RAPD-PCR yields were electrophoresed on a 1 .5% agarose gel and visualized using ethidium-bromide staining. Only two out of the selected RAPD data have exhibited distinguishable polymorphic markers between cancerous and normal tissues. Enzyme-Linked Immunosorbent Assay (ELISA) was used for the determination plasma immunoglobulins (IgG, IgA and IgM) in patient samples preoperatively, postoperatively and after six cycles of chemotherapy treatment. Thirty age-matched normal females were examined for IgA, IgG and IgM by ELISA. Specifi cally, results showed that normal females had mean IgG, IgA and IgM concentrations of 9.80mg/ml, 2.56mg/ml, and 1.75mg/ml respectively while malignant patients preoperatively had mean concentration of 9.89mg/ml, 2.92mg/ml and 2.02mg/ml (P<0.727, P<0.001 and P<0.001) respectively. Moreover, analysis of the data revealed that patient plasma samples concentrations of IgG, IgA and IgM postoperatively were 7.9mg/ml, 1.96mg/ml and 1.36mg/ml (P<0.001) respectively whereas, their concentrations improved to normal levels when chemotherapy was ceased. Bovine Serum Albumin (BSA) was chosen as a goal to minimize cross linking and investigate differences in immunoglobulin concentrations. On the other hand, the mean levels of IgA and IgM in patient plasma samples preoperatively after refi ning from antibody binding process that interfere with BSA were measured to be 2.53mg/ml and 1.72mg/ml respectively demonstrating that there were no statistical signifi cance of the difference between IgA and IgM concentrations in malignant patients and healthy females. Hence, this study aimed to assess the prevalence of cross reactivity with BSA that might be used as a potent marker for patients with breast cancer.

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“…Although the exact pathophysiology of cancers in patients with autoimmune diseases has not been fully determined, several mechanisms have been suggested to contribute to the high susceptibility of distinct groups of patients to specific malignancies 83, 84. These mechanisms include impaired genetic stability, genetic predisposition, immune dysregulation, impaired clearance of oncogenic viruses, and iatrogenic causes 85, 86.…”

Section: Discussionmentioning

confidence: 99%

Recurrent aphthous stomatitis may be a precursor or risk factor for specific cancers: A case‐control frequency‐matched study

et al. 2018

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BackgroundRecurrent aphthous stomatitis (RAS) is considered a prophase symptom in patients with specific cancers. This study assessed the association between RAS and subsequent onset of cancer based on a nationwide population‐based database in Taiwan.Materials and MethodsWe selected study participants from the National Health Insurance Research Database from January 2000 to December 2008. Patients in the non‐RAS cohort were matched to case study patients at a 1:1 ratio through frequency matching. All participants were followed up for at least 5 years, and those who received cancer diagnoses during follow‐up were identified.ResultsAmong 52 307 patients with and 52 304 patients without RAS, the combined hazard ratio (HR) of all subsequent cancer cases was 1.3 (95% confidence interval [CI]: 1.25‐1.35, P = 0). RAS diagnosis was associated with risk for cancers of the head and neck (aHR = 2, 95% CI: 1.8‐2.3), colon (aHR = 1.2, 95% CI: 1.1‐1.4), liver (aHR = 1.1, 95% CI: 1‐1.3), pancreas (aHR = 1.4, 95% CI: 1.1‐1.7), skin (aHR = 1.4, 95% CI: 1.2‐1.7), breast (aHR = 1.2, 95% CI: 1.1‐1.4), and prostate (aHR = 1.5, 95% CI: 1.3‐1.8), as well as hematologic cancers (aHR = 1.6, 95% CI: 1.3‐1.9). A higher risk was observed for male patients (aHR = 1.35, 95% CI: 1.28‐1.42) than for female patients (aHR = 1.25, 95% CI: 1.18‐1.31) with RAS.Conclusions RAS was associated with specific cancers. Susceptible RAS patients should be screened for specific cancers.

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Cancer and autoimmune diseases

Cited by 158 publications

References 104 publications

Clinical Outcomes of Patients with Advanced Cancer and Pre-Existing Autoimmune Diseases Treated with Anti-Programmed Death-1 Immunotherapy: A Real-World Transverse Study

Clinical Outcomes of Patients with Advanced Cancer and Pre-Existing Autoimmune Diseases Treated with Anti-Programmed Death-1 Immunotherapy: A Real-World Transverse Study

Evaluation of breast cancer regarding molecular and immunochemical markers

Recurrent aphthous stomatitis may be a precursor or risk factor for specific cancers: A case‐control frequency‐matched study

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