RT Journal Article
SR Electronic
T1 Immune-related Adverse Events Associated with Cancer Immunotherapy: A Review for the Practicing Rheumatologist
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.190084
DO 10.3899/jrheum.190084
A1 Shahin Jamal
A1 Marie Hudson
A1 Aurore Fifi-Mah
A1 Carrie Ye
YR 2019
UL http://www.jrheum.org/content/early/2019/07/10/jrheum.190084.abstract
AB Immune checkpoint inhibitors have revolutionized cancer therapy by blocking inhibitory pathways of the immune system to fight cancer cells. Their use is often limited by the development of autoimmune toxicities, which can affect multiple organ systems and are referred to as immune-related adverse events (irAE). Amongst these are rheumatologic irAE, including inflammatory arthritis, myositis, vasculitis, and others. Rheumatologic irAE seem to be different from irAE in other organs and from traditional autoimmune diseases in that they can occur early or have delayed onset, and can persist chronically, even after cancer therapy is terminated. As immune checkpoint inhibitors are increasingly used for many types of cancer, it is important for oncologists and rheumatologists to recognize and manage toxicities early. In this review, we discuss currently approved immune checkpoint inhibitors, their mechanisms of action and systemic toxicities, with focus on rheumatic immune related adverse events, their management and impact on further cancer therapy.