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Review ArticleReview
Open Access

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

Shahin Jamal, Marie Hudson, Aurore Fifi-Mah and Carrie Ye
The Journal of Rheumatology February 2020, 47 (2) 166-175; DOI: https://doi.org/10.3899/jrheum.190084
Shahin Jamal
From the Division of Rheumatology, Vancouver General Hospital, and Department of Medicine, University of British Columbia, Vancouver, British Columbia; Division of Rheumatology, Jewish General Hospital and Lady Davis Institute; Department of Medicine, McGill University, Montreal, Quebec; Division of Rheumatology, University of Calgary, Calgary; Division of Rheumatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
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  • For correspondence: Shahin.jamal@vch.ca
Marie Hudson
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Aurore Fifi-Mah
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Carrie Ye
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Abstract

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). Among 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. Because 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 and their mechanisms of action and systemic toxicities, with a focus on the management and effect on further cancer therapy of rheumatic irAE.

Key Indexing Terms:
  • IMMUNE CHECKPOINT INHIBITORS
  • ADVERSE EVENTS
  • IMMUNOTHERAPY
  • INFLAMMATORY ARTHRITIS
  • MYOSITIS
  • VASCULITIS
  • Accepted for publication June 28, 2019.

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The Journal of Rheumatology
Vol. 47, Issue 2
1 Feb 2020
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Immune-related Adverse Events Associated with Cancer Immunotherapy: A Review for the Practicing Rheumatologist
Shahin Jamal, Marie Hudson, Aurore Fifi-Mah, Carrie Ye
The Journal of Rheumatology Feb 2020, 47 (2) 166-175; DOI: 10.3899/jrheum.190084

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Immune-related Adverse Events Associated with Cancer Immunotherapy: A Review for the Practicing Rheumatologist
Shahin Jamal, Marie Hudson, Aurore Fifi-Mah, Carrie Ye
The Journal of Rheumatology Feb 2020, 47 (2) 166-175; DOI: 10.3899/jrheum.190084
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Keywords

IMMUNE CHECKPOINT INHIBITORS
ADVERSE EVENTS
IMMUNOTHERAPY
INFLAMMATORY ARTHRITIS
MYOSITIS
VASCULITIS

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Keywords

  • IMMUNE CHECKPOINT INHIBITORS
  • ADVERSE EVENTS
  • IMMUNOTHERAPY
  • inflammatory arthritis
  • myositis
  • vasculitis

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