Successful use of an immune checkpoint inhibitor in a patient with myasthenia gravis in remission

Jordan, Berit; Zierz, Stephan; Weber, Thomas; Jordan, Karin

doi:10.1002/mus.26495

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…The treatment was well tolerated and did not result in exacerbations of Crohn's disease. Last, recent case reports documented successful use of nivolumab in a patient with myasthenia gravis in remission [47], of the same drug in a patient with lung cancer and concomitant lupus erythematosus plus HCV infection [48], of pembrolizumab in a patient with melanoma and rheumatoid arthritis [49], and of avelumab in a patient with Merkel cell carcinoma, HIV infection, and sarcoidosis [50].…”

Section: Successful Responsementioning

confidence: 99%

Immunotherapy in Underrepresented Populations of Patients with Cancer: Do We Have Enough Evidence at Present? A Focus on Patients with Major Viral Infections and Autoimmune Disorders

Antonuzzo

Calabrò

Quaglino³

et al. 2020

The Oncologist

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The safety and activity of immune checkpoint inhibitors have been characterized in interventional and observational studies. However, only small studies have specifically investigated these agents in patients who are excluded or underrepresented in clinical trials, frequently referred to as “special populations” or “underrepresented populations.” These include older adults, those with dysregulated immune activation, patients with a compromised immune function, and those carrying major viral infections, lymphoproliferative diseases, and major organ dysfunctions. Therefore, there remains substantial uncertainty regarding the use of immune checkpoint inhibitors in these specific settings. The Network of Italian Supportive Care in Oncology has carried out a multidisciplinary project, with the contribution of oncologists and other specialists, to retrieve the existing evidence on the use of immunotherapy in patients with solid and hematological cancers with the final aim to provide an expert guidance. The results of this effort are presented in this article, which is focused on patients with major viral infections or those with immune dysregulation/autoimmune diseases, and could be useful to guide decisions in clinical practice and to design prospective clinical trials focusing on the use of immunotherapy in these populations. Implications for Practice Substantial uncertainty remains regarding the use of immune checkpoint inhibitors in “underrepresented” patients, such as older adults, those with dysregulated immune activation, and patients with a compromised immune function, major viral infections, lymphoproliferative diseases or major organ dysfunctions. The Network of Italian Supportive Care in Oncology has carried out a multidisciplinary project to retrieve the existing evidence on the use of immunotherapy in underrepresented patients with cancer in order provide an expert guidance. The results of this effort, with a focus on patients with major viral infections or those with immune dysregulation/autoimmune diseases, are presented in this article and could be useful to guide decisions both in clinical practice and to design clinical trials.

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Section: Successful Responsementioning

confidence: 99%

Immunotherapy in Underrepresented Populations of Patients with Cancer: Do We Have Enough Evidence at Present? A Focus on Patients with Major Viral Infections and Autoimmune Disorders

Antonuzzo

Calabrò

Quaglino³

et al. 2020

The Oncologist

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Pembrolizumab treatment of metastatic urothelial cancer without exacerbating myasthenia gravis

et al. 2020

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The Safety and Efficacy of Immune-Checkpoint Inhibitors in Patients with Cancer and Pre-Existing Autoimmune Diseases

Zhong

et al. 2021

Immunotherapy

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Objective: This study aims at investigating the safety and efficacy of immune-checkpoint inhibitors (ICIs) in patients with cancer and pre-existing autoimmune disease (AID). Materials & methods: PubMed, Embase and Cochrane Library were searched for relevant studies. The primary end points of the study were immunotoxicity and cancer response. Results: At the early use of ICIs, compared with those with active AID, grade 3–4 AID flare occurred more frequently in patients with inactive AID after treatment with ICIs; and the incidence of grade 3–4 immunotoxic effects was significantly lower in patients undergoing immunosuppressive therapy than those without corresponding treatment. In addition, patients with worsening AID generally obtained a better objective response than those without a flare. Conclusion: This study demonstrates that the toxic effects induced by immunotherapy are generally manageable in patients with cancer and pre-existing AID, some of whom even achieve satisfactory antitumor effects in clinical practice.

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Successful use of an immune checkpoint inhibitor in a patient with myasthenia gravis in remission

Cited by 3 publications

References 6 publications

Immunotherapy in Underrepresented Populations of Patients with Cancer: Do We Have Enough Evidence at Present? A Focus on Patients with Major Viral Infections and Autoimmune Disorders

Immunotherapy in Underrepresented Populations of Patients with Cancer: Do We Have Enough Evidence at Present? A Focus on Patients with Major Viral Infections and Autoimmune Disorders

Pembrolizumab treatment of metastatic urothelial cancer without exacerbating myasthenia gravis

The Safety and Efficacy of Immune-Checkpoint Inhibitors in Patients with Cancer and Pre-Existing Autoimmune Diseases

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