Immune-related Adverse Events Associated with Cancer Immunotherapy: A Review for the Practicing Rheumatologist

Jamal, Shahin; Hudson, Marie; Fifi‐Mah, Aurore; Ye, Carrie

doi:10.3899/jrheum.190084

Cited by 60 publications

(30 citation statements)

References 82 publications

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“…We described a case of polyarthritis that were reported only on five clinical trials with a range of 1% -7% in the meta-analysis of Capelli et al Dry eyes were most commonly reported with a range of incidence of 3% -24% In this study, two cases of polyarthritis and tenosynovitis after treatment of Pembrolizumabsimilar to our observation, have been also reported [7]. Time to onset of polyarthritis is generally 4 -8 weeks after initiation of ICIs, however they have been reported after one dose or up two years after receiving these therapies [3] [14]. In the majority of cases, the auto-antibodies are negative, al-…”

Section: Discussionsupporting

confidence: 73%

“…though Rheumatoid Factor (RF) or anti-citrullinated cyclic peptide positive cases have been reported[3] [15]. In our observation RF was positive with a low titer; other auto-antibodies were negative.Rh-irAES are managed according to severity assessed using Common Terminology Criteria for Adverse Events grading system[10].…”

mentioning

confidence: 43%

“…Rheumatologic irAEs (Rh-irAEs) had been reported with a wide spectrum of clinical manifestations including arthralgias, myalgias, inflammatory arthritis, rheumatoid arthritis-like, polymyalgia rheumatica-like, lupus-like sicca syndrome, myositis and vasculitis [3] [13]. We described a case of polyarthritis that were reported only on five clinical trials with a range of 1% -7% in the meta-analysis of Capelli et al Dry eyes were most commonly reported with a range of incidence of 3% -24% In this study, two cases of polyarthritis and tenosynovitis after treatment of Pembrolizumabsimilar to our observation, have been also reported [7].…”

Section: Discussionmentioning

confidence: 99%

“…ment of various cancers [1] [2]. Indeed, the widespread use of ICIs has led to remarkable clinical outcomes, with complete remissions and sustained clinical responses seen in some patients with previously refractory cancers such as metastatic melanoma, lung cancer, renal cell carcinoma, and Hodgkin lymphoma [3] [4].…”

Section: Introductionmentioning

confidence: 99%

“…However, activating immune system to fight cancer can also lead to immune related adverse events (irAEs) [3] [5].…”

Section: Introductionmentioning

confidence: 99%

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Polyarthritis, Tenosynovitis and Dry Eyes after Treatment by Immune Check-Point Inhibitors

Kane¹,

Ould-Hennia²,

Karaa-Zbidi³

et al. 2020

OJRA

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Introduction: Immune checkpoint inhibitors targeting programmed death protein-1 and cytotoxic-T-lymphocyte-antigen-4 have revolutionized the treatment of various cancers. Despite their effectiveness, these therapies can lead to immune related adverse events. Observation: We reported a case of a 43year-old white woman who was referred to our department for a management of acute polyarthritis. She was followed for a relapsing metastatic melanoma (stage IIIb) by surgery and Pembrolizumab, an immune checkpoint inhibitor targeting programmed death protein-1. After receiving her 4 th cycle of this therapy she developed arthritis of the knees and the ankles, tenosynovitis and dry eyes with keratitis. After exclusion of other causes of polyarthritis such as connective-tissue disease, the diagnosis of rheumatologic immunerelated adverse events was retained. She was treated by 20 mg of prednisone daily, Pembrolizumab was discontinued. The evolution was favorable. Conclusion: Rheumatologic manifestations secondary to immune checkpoint inhibitors have been less well described in the literature. Their management requires the collaboration of oncologists and rheumatologists to limit the diagnostic delay and for an appropriate therapeutic choice according to their severity.

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Section: Discussionsupporting

confidence: 73%

mentioning

confidence: 43%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…However, activating immune system to fight cancer can also lead to immune related adverse events (irAEs) [3] [5].…”

Section: Introductionmentioning

confidence: 99%

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Polyarthritis, Tenosynovitis and Dry Eyes after Treatment by Immune Check-Point Inhibitors

Kane¹,

Ould-Hennia²,

Karaa-Zbidi³

et al. 2020

OJRA

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Association of Immune-Related Adverse Events With Efficacy of Atezolizumab in Patients With Non–Small Cell Lung Cancer

et al. 2023

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ImportanceImmune-related adverse events (irAEs) arising from immune checkpoint inhibitor (ICI) cancer therapy may potentially predict improved outcomes.ObjectiveTo evaluate the association between irAEs and atezolizumab efficacy in patients with advanced non–small cell lung cancer (NSCLC) using pooled data from 3 phase 3 ICI studies.Design, Setting, and ParticipantsIMpower130, IMpower132, and IMpower150 were phase 3, multicenter, open-label, randomized clinical trials to evaluate the efficacy and safety of chemoimmunotherapy combinations involving atezolizumab. Participants were chemotherapy-naive adults with stage IV nonsquamous NSCLC. These post hoc analyses were conducted during February 2022.InterventionsEligible patients were randomly assigned 2:1 to receive atezolizumab with carboplatin plus nab-paclitaxel, or chemotherapy alone (IMpower130); 1:1 to receive atezolizumab with carboplatin or cisplatin plus pemetrexed, or chemotherapy alone (IMpower132); and 1:1:1 to receive atezolizumab plus bevacizumab plus carboplatin and paclitaxel, atezolizumab plus carboplatin and paclitaxel, or bevacizumab plus carboplatin and paclitaxel (IMpower150).Main Outcomes and MeasuresPooled data from IMpower130 (cutoff: March 15, 2018), IMpower132 (cutoff: May 22, 2018), and IMpower150 (cutoff: September 13, 2019) were analyzed by treatment (atezolizumab-containing vs control), irAE status (with vs without), and highest irAE grade (1-2 vs 3-5). To account for immortal bias, a time-dependent Cox model and landmark analyses of irAE occurrence at 1, 3, 6, and 12 months from baseline were used to estimate the hazard ratio (HR) of overall survival (OS).ResultsOf 2503 randomized patients, 1577 were in the atezolizumab-containing arm and 926 were in the control arm. The mean (SD) age of patients was 63.1 (9.4) years and 63.0 (9.3) years, and 950 (60.2%) and 569 (61.4%) were male, respectively, in the atezolizumab arm and the control arm. Baseline characteristics were generally balanced between patients with irAEs (atezolizumab, n = 753; control, n = 289) and without (atezolizumab, n = 824; control, n = 637). In the atezolizumab arm, OS HRs (95% CI) in patients with grade 1 to 2 irAEs and grade 3 to 5 irAEs (each vs those without irAEs) in the 1-, 3-, 6-, and 12-month subgroups were 0.78 (0.65-0.94) and 1.25 (0.90-1.72), 0.74 (0.63-0.87) and 1.23 (0.93-1.64), 0.77 (0.65-0.90) and 1.1 (0.81-1.42), and 0.72 (0.59-0.89) and 0.87 (0.61-1.25), respectively.Conclusions and RelevanceIn this pooled analysis of 3 randomized clinical trials, longer OS was observed in patients with vs without mild to moderate irAEs in both arms and across landmarks. These findings further support the use of first-line atezolizumab-containing regimens for advanced nonsquamous NSCLC.Trial RegistrationClinicalTrials.gov Identifiers: NCT02367781, NCT02657434, and NCT02366143

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Autoimmune Phenomena in Cancer Patients Treated with Immune Checkpoint Inhibitors

Tocut,

Ehrenfeld,

Zandman‐Goddard

2024

Autoimmune Disorders

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Immune-related Adverse Events Associated with Cancer Immunotherapy: A Review for the Practicing Rheumatologist

Cited by 60 publications

References 82 publications

Polyarthritis, Tenosynovitis and Dry Eyes after Treatment by Immune Check-Point Inhibitors

Polyarthritis, Tenosynovitis and Dry Eyes after Treatment by Immune Check-Point Inhibitors

Association of Immune-Related Adverse Events With Efficacy of Atezolizumab in Patients With Non–Small Cell Lung Cancer

Autoimmune Phenomena in Cancer Patients Treated with Immune Checkpoint Inhibitors

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