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 and 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."