medwireNews: A French database analysis lends further support for the use immune checkpoint inhibitors for cancer in patients with pre-existing autoimmune disease.
Among 112 individuals with autoimmune disease – most commonly psoriasis (n=31) and rheumatoid arthritis (n=20) – who received checkpoint blockade most frequently for melanoma (n=66) or non-small-cell lung cancer (n=40) between 2017 and 2018, flares and/or immune-related adverse events (irAEs) occurred in 71% over a median 8 months of follow-up.
Forty-three percent of these patients required immunosuppressive therapy for the flare/irAE, 21% had to permanently discontinue the immunotherapeutic agent, and there was one death attributable to an irAE.
Researcher Divi Cornec, from CHU Brest, and collaborators note that flares and/or irAEs were “frequent and potentially severe,” but they nonetheless believe that individuals with pre-existing autoimmune disease “are good candidates” for immune checkpoint inhibitors.
“Close follow-up and collaboration between oncologists and organ specialists is mandatory in managing such patients,” they write in Arthritis & Rheumatology.
The researchers also identified an association between the use of immunosuppressive therapy at baseline and poor cancer outcomes, but they stress that “further prospective studies are needed to draw firm conclusions.”
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