Cancer Immunotherapy: Knowing the Immune-related Adverse Events

Immunotherapy in cancer has revolutionized cancer treatment and has become a universal answer to the question “how can we treat cancer?” However, checkpoint inhibitors (CPIs), a type of immunotherapy, is associated with a new group of immune-related adverse events (irAEs) in almost any organ system. In a recent study published in Nature Reviews Rheumatology, researchers outline these new questions and unmet needs that rheumatologists might be dealing with more. 

Our new #Review on Rheumatic immune-related adverse events from cancer immunotherapy is online now! @LCalabreseDO
Check it out at https://t.co/eA0IpaAQ4o pic.twitter.com/u4GctmV37d

— NatRevRheumatol (@NatRevRheumatol) September 1, 2018

According to the review, treatment of irAEs often requires immunosuppression with glucocorticoids, which are sometimes administered with conventional synthetic or biologic disease-modifying drugs. And although rheumatoid irAEs are not as common as traditional irAEs, they are underdiagnosed and less well recognized which is half of the problem. The review also states that rheumatic irAEs seem to be nosologically distinct, occurring both early and late in response to CPI therapy. To make matters worse, a substantial proportion of them are chronic, persisting even after cessation of CPI therapy. 

irAEs from cancer IMMUNOTHERAPY should be the domain for RHEUMATOLOGISTS to lead in both research and care – WE DO MULTISYTEM AUTOIMMUNITY for a living!!!!! @jhrheumatology @CleClinicMD @HealioRheum @HealioRheum #CleClinicCancer #immunotherapy @MikkaelSekeres @VamsiVelcheti https://t.co/ltH5w8JzzY

— Leonard Calabrese (@LCalabreseDO) September 1, 2018

Rheumatic related adverse events seem to be nosologically distinct, occurring both early and late in response to Check points inh (CPI) therapy. A proportion of them are chronic, persisting even after cessation of CPI therapy. @LCalabreseDO @CCalabreseDO https://t.co/DBq61Gk740

— Reumatología Clinic (@Reumaclinic) September 3, 2018

“Rheumatologists must be prepared for irAEs and contribute to inter-professional teams in managing immunotherapy for patients with cancer,” the researchers concluded. 

Check out an article on if a specific serum biomarker could positively impact patient survival. 

SOURCE: Nature Reviews Rheumatology