Pre-existing autoimmune disease and the risk of immune-related adverse events among patients receiving checkpoint inhibitors for cancer

Kehl, Kenneth L.; Yang, Shihao; Awad, Mark M.; Palmer, Nathan; Kohane, Isaac S.; Schrag, Deborah

doi:10.1007/s00262-019-02321-z

Cited by 66 publications

(52 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A few other smaller case series have also reported on the frequency of disease flares and de novo IRAEs in patients with prior autoimmune disease receiving ICIs as treatment for concomitant cancer . Results have generally been similar to those reported by Tison et al, with approximately half of the patients developing a flare.…”

supporting

confidence: 75%

“…While almost half of patients will experience a flare of their underlying autoimmune disease and many will have new IRAEs, these complications can usually be managed with glucocorticoids or other therapies. A recent study found no differences in hospitalization for any cause after ICI treatment for people with and those without preexisting autoimmune disease, although those with autoimmune disease had an increase in IRAE‐related admissions and a greater likelihood of receiving glucocorticoid treatment .…”

mentioning

confidence: 94%

See 1 more Smart Citation

Is Immune Checkpoint Inhibitor Treatment an Option for Patients With Rheumatic Diseases and Cancer?

Buckley

Suarez‐Almazor

2019

Arthritis & Rheumatology

View full text Add to dashboard Cite

supporting

confidence: 75%

mentioning

confidence: 94%

Is Immune Checkpoint Inhibitor Treatment an Option for Patients With Rheumatic Diseases and Cancer?

Buckley

Suarez‐Almazor

2019

Arthritis & Rheumatology

View full text Add to dashboard Cite

“…In the future, as ICIs are increasingly utilized for malignancies typically associated with paraneoplastic neurological syndromes (eg, small cell cancer, thymoma, germ cell tumors) and patients with pre‐existing autoimmunity, the frequency of high‐grade irAE‐N may increase further . The temporal course of irAE‐Ns in relation to ICI initiation, along with clinical and diagnostic features consistent with an immune‐mediated etiology and exclusion of other potential causes, supports the causal relationship between ICI use and the onset of neurological symptoms in these patients.…”

Section: Frequency Of Severe Irae‐n and Associated Ici Classesmentioning

confidence: 75%

Severe Neurological Toxicity of Immune Checkpoint Inhibitors: Growing Spectrum

Dubey

David

Reynolds

et al. 2020

Annals of Neurology

161

189

View full text Add to dashboard Cite

Expanding use of immune-checkpoint inhibitors (ICIs) underscores the importance of accurate diagnosis and timely management of neurological immune-related adverse events (irAE-N). We evaluate the real-world frequency, phenotypes, co-occurring immune-related adverse events (irAEs), and long-term outcomes of severe, grade III to V irAE-N at a tertiary care center over 6 years. We analyze how our experience supports published literature and professional society guidelines. We also discuss these data with regard to common clinical scenarios, such as combination therapy, ICI rechallenge and risk of relapse of irAE-N, and corticosteroid taper, which are not specifically addressed by current guidelines and/or have limited data. Recommendations for management and future irAE-N reporting are outlined.

show abstract

“…A serious case of metastatic melanoma patients resumed PD-1 therapy after suffering from combination ICIs treated-related toxicities, ultimately, 39% of patients experienced clinically significant recurrent or distinct toxicities ( 83 ). Recently, multivariable analyses showed whether the pre-existing ADs identified by strict criteria or relaxed criteria were both associated with the ICIs-related toxicities diagnosis during hospitalization therapy resumption ( 84 ). These results consistently indicated that pre-existing ADs may be a predictor of toxicity.…”

Section: Combined Predictive Biomarkersmentioning

confidence: 99%

Predictive Biomarkers of Immune Checkpoint Inhibitors-Related Toxicities

Zhu

et al. 2020

Front. Immunol.

View full text Add to dashboard Cite

The emergence and continuous development of immune checkpoint inhibitors (ICIs) therapy brings a revolution in cancer therapy history, but the major hurdle associated with their usage is the concomitant ICIs-related toxicities that present a challenge for oncologists. The toxicities may involve non-specific symptoms of multiple systems as for the unique mechanism of formation, which are not easily distinguishable from traditional toxicities. A few of these adverse events are self-limiting and readily manageable, but others may limit treatment, cause interruption and need to be treated with methylprednisolone or tumor necrosis factor-α (TNF-α) antibody infliximab, and even directly threaten life. Early accurate recognition and adequate management are critical to the patient's prognosis and overall survival (OS). Several biomarkers such as the expression of programmed cell death ligand 1 (PD-L1), tumor mutation burden (TMB), and microsatellite instability-high (MSI-H)/mismatch repair-deficient (dMMR) have been proved to be the predictors for anti-tumor efficacy of ICIs, but there is a gap in clinical needs for effective biomarkers that predict toxicities and help filter out the patients who may benefit most from these costly therapies while avoiding major risks of toxicities. Here, we summarize several types of risk factors correlated with ICIs-related toxicities to provide a reference for oncologists to predict the occurrence of ICIs-related toxicities resulting in a timely process in clinical practice.

show abstract

Pre-existing autoimmune disease and the risk of immune-related adverse events among patients receiving checkpoint inhibitors for cancer

Cited by 66 publications

References 37 publications

Is Immune Checkpoint Inhibitor Treatment an Option for Patients With Rheumatic Diseases and Cancer?

Is Immune Checkpoint Inhibitor Treatment an Option for Patients With Rheumatic Diseases and Cancer?

Severe Neurological Toxicity of Immune Checkpoint Inhibitors: Growing Spectrum

Predictive Biomarkers of Immune Checkpoint Inhibitors-Related Toxicities

Contact Info

Product

Resources

About