In the largest single-center study of patients with rheumatologic diseases who were prescribed modern cancer immunotherapy with what are called immune checkpoint inhibitors, only a minority of patients experienced a flare of their rheumatologic disease or immune-related side effects.
The Arthritis & Rheumatology study included 16 patients with rheumatologic diseases--including rheumatoid arthritis, polymyalgia rheumatica, Sjogren's syndrome, and systemic lupus erythematosus--who were later diagnosed with cancer. After initiating cancer immunotherapy, immune-related adverse effects occurred in 6 patients, and all were treated successfully. The findings suggest that selected groups of patients with rheumatologic disease can safely receive potentially life-saving cancer treatments.
"Based on our observations, immune checkpoint inhibitor therapy should be considered in select patients with pre-existing rheumatologic disease," said senior author Dr. Uma Thanarajasingam, of the Mayo Clinic. "However, there is an immediate and pressing need for prospective, and ideally multi-center trials to study rheumatic patients who go on to need immune checkpoint inhibitor therapy - both to better understand their safety profile in this under-studied patient group, as well as elucidate risk factors and biomarkers for the development of immune-related adverse effects."