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08-02-2018 | Cancer immunotherapy | News

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Further support for checkpoint inhibitor use in patients with rheumatic diseases

medwireNews: A single-center study adds support to the contention that immune checkpoint inhibitors need not be withheld from cancer patients with pre-existing rheumatic conditions.

Among 5200 patients with cancer who received ipilimumab, nivolumab, pembrolizumab, or a combination of these agents between 2011 and 2016, 16 had a confirmed diagnosis of a rheumatic disease, most commonly rheumatoid arthritis and polymyalgia rheumatica.

And of these, six (37.5%) patients experienced an immune-related adverse event (irAE), of which three were incidences of colitis and one a flare-up of the existing condition.

Lead author Uma Thanarajasingam (Mayo Clinic, Rochester, Minnesota, USA) and team report in Arthritis & Rheumatology that although four of the irAEs were of grade 3 or worse, all were managed successfully with corticosteroids and discontinuation of the checkpoint inhibitors.

Noting that the incidence of irAEs in the general population can be as high as 70–90%, they therefore believe that “routinely withholding [immune checkpoint inhibitor] therapy in these patients is unfounded.”

However, the study authors caution that “treatment decisions must factor in clinical judgement.”

By Shreeya Nanda

medwireNews is an independent medical news service provided by Springer Healthcare. © 2018 Springer Healthcare part of the Springer Nature group

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