Checkpoint inhibitor-associated autoimmunity |
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| Affiliation: | 1. McMaster University, Canada;2. Hospital for Special Surgery, Weill Cornell Medicine, United States;1. Department of Dermatology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;2. University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;3. Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pennsylvania;4. Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;5. McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;6. Hillman Cancer Center, University of Pittsburg Medical Center, Pittsburgh, Pennsylvania;1. Department of Medicine, Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Canada;2. Department of Dermatology, Ha''emek Medical Center, Afula, Israel;3. Faculty of Medicine, University of Toronto, Toronto, Canada;4. Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada;5. Burn Unit, The Hospital for Sick Children, University of Toronto, Canada;6. Division of Clinical Pharmacology and Toxicology, University of Toronto, Toronto, Canada;1. Dermatology, Ohio State University College of Medicine, Columbus, Ohio;2. Dermatology, University of Pennsylvania Hospital, Philadelphia, Pennsylvania;1. Department of Dermatology, Keio University School of Medicine, Tokyo, Japan;2. Department of Hematology, Keio University School of Medicine, Tokyo, Japan;1. Division of Dermatology, Department of Medicine, University of Cape Town, Cape Town, South Africa;2. Drug Allergy Clinic, Groote Schuur Hospital, Cape Town, South Africa;3. School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa;4. Division of Allergology, Department of Medicine, University of Cape Town, Cape Town, South Africa |
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| Abstract: | Checkpoint inhibitors (CI) have revolutionized the management of many cancers but can result in immune-related adverse events (IRAE). In this chapter, we review the clinical manifestations and management of the most common IRAE, plus less common IRAE, such as inflammatory arthritis, of particular interest to rheumatologists. We review the mechanism of action of CI, predictors of IRAE, and the impact of IRAE on cancer outcomes. The study of IRAE is in its infancy; there are very few prospective studies and virtually no treatment trials. Where possible, we have drawn estimates of IRAE incidence from meta-analyses of randomized controlled trials. Clinical descriptions are derived from case series and case reports. Readers are encouraged to refer to consensus guidelines for IRAE management published by the American Society of Clinical Oncology and the Society for Immunotherapy of Cancer. |
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| Keywords: | Immune checkpoint inhibitor Immunotherapy Immune-related adverse event Inflammatory arthritis Myositis |
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