Rheumatic immune-related adverse events from cancer immunotherapy

被引:166
作者
Calabrese, Leonard H. [1 ]
Calabrese, Cassandra [1 ]
Cappelli, Laura C. [2 ]
机构
[1] Case Western Reserve Univ, Cleveland Clin Fdn, Dept Rheumat & Immunol Dis, Cleveland Clin,Lerner Coll Med, Cleveland, OH 44106 USA
[2] Johns Hopkins Sch Med, Div Rheumatol, Baltimore, MD USA
关键词
CHECKPOINT INHIBITORS; PREEXISTING AUTOIMMUNE; INFLAMMATORY ARTHRITIS; PSORIATIC-ARTHRITIS; IPILIMUMAB THERAPY; ADVANCED MELANOMA; T-CELLS; NIVOLUMAB; TOXICITY; PATIENT;
D O I
10.1038/s41584-018-0074-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Immunotherapy has revolutionized the treatment of cancer, but a rapid rise in the use of the family of therapeutic agents known as checkpoint inhibitors (CPIs) is associated with a new group of immune-related adverse events (irAEs) in almost any organ system. Among these irAEs, rheumatic complications are common and seem to have features that are distinct from irAEs in other organ systems, including a highly variable time of clinical onset and the capacity to persist, possibly indefinitely, even after cessation of CPI therapy. In this Review, mechanisms of action of CPIs and how they might cause rheumatic irAEs are described. Also covered are epidemiology and clinical descriptions of rheumatic irAEs, plus guiding principles for managing irAEs. Finally, we outline future directions that must be taken in response to a series of unanswered questions and unmet needs that now confront rheumatologists who are, or will be, engaged in this new area of rheumatology.
引用
收藏
页码:569 / 579
页数:11
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