Cancer immunotherapy in patients with preexisting rheumatic diseases: Other rheumatic autoimmune diseases

Abstract

In clinical practice, the major efficacy of immune checkpoint inhibitors (ICIs) prompts clinicians to propose them to a wider population, such as patients with pre-existing rheumatic autoimmune diseases. So far, approximately 50 patients with pre-existing rheumatic conditions other than inflammatory arthritis have been reported being treated with ICIs. There are no dedicated guidelines regarding the management of such patients. Owing to concerns regarding antitumor efficacy, tapering baseline immunosuppressive treatment seems a logical strategy but may lead to an increased risk of autoimmune flare and/or other immune toxicity. However, patients who experienced flare of their pre-existing autoimmune disease were likely managed with systemic glucocorticoids.