scholarly journals Immune checkpoint inhibitor-induced inflammatory arthritis persists after immunotherapy cessation

2019 ◽  
Vol 79 (3) ◽  
pp. 332-338 ◽  
Author(s):  
Tawnie J Braaten ◽  
Julie R Brahmer ◽  
Patrick M Forde ◽  
Dung Le ◽  
Evan J Lipson ◽  
...  
Keyword(s):  
Immune Checkpoint ◽  
Inflammatory Arthritis ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Tumour Response ◽  
Cox Proportional Hazards ◽  
Immunomodulatory Treatment ◽  
The Impact

ObjectiveWe sought to investigate the long-term outcomes of patients who develop immune checkpoint inhibitor (ICI)-induced inflammatory arthritis (IA), to define factors associated with IA persistence after ICI cessation, the need for immunosuppressants and the impact of these medications on underlying malignancies.MethodsWe conducted a prospective observational study of patients referred for IA associated with ICIs. Patients were recruited from June 2015 to December 2018. Information was obtained at the baseline visit, and follow-up visits occurred at varying intervals for up to 24 months from ICI cessation. Kaplan-Meier curves were developed to characterise IA persistence. Cox proportional hazards models were used to assess the influence of various factors on IA persistence. Logistic regression was used to evaluate the impact of IA treatment on tumour response.ResultsSixty patients were monitored with a median follow-up after ICI cessation of 9 months. A majority (53.3%) had active IA at their most recent follow-up. IA was less likely to improve in those with longer duration of ICI use, in those receiving combination ICI therapy, and in patients with multiple other immune-related adverse events. Tumour response did not appear to be impacted by immunosuppression. Although not statistically significant, persistent IA was correlated with a better tumour response (complete or partial response).ConclusionICI-induced IA can become a long-term disease necessitating management by rheumatology for immunomodulatory treatment. Importantly, the use of immunomodulatory treatment has not been shown to impact cancer outcomes in this study.

Fr507 IMMUNE CHECKPOINT INHIBITOR RESUMPTION IS ASSOCIATED WITH BETTER LONG TERM OUTCOMES IN CANCER PATIENTS

2021 ◽  
Vol 160 (6) ◽  
pp. S-337
Author(s):  
Fangwen Zou ◽  
Anusha Shirwaikar Thomas ◽  
Barbara E. Dutra ◽  
Shruti Khurana ◽  
Isabella C. Glitza Oliva ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Long Term Outcomes

scholarly journals Association of HLA-DRB1 shared epitope alleles and immune checkpoint inhibitor-induced inflammatory arthritis

Rheumatology ◽  
2018 ◽  
Vol 58 (3) ◽  
pp. 476-480 ◽  
Author(s):  
Laura C Cappelli ◽  
Mehmet T Dorak ◽  
Maria P Bettinotti ◽  
Clifton O Bingham ◽  
Ami A Shah
Keyword(s):  
Immune Checkpoint ◽  
Inflammatory Arthritis ◽  
Immune Checkpoint Inhibitor ◽  
Shared Epitope ◽  
Checkpoint Inhibitor ◽  
Hla Class I ◽  
Hla Typing ◽  
Healthy Controls ◽  
European Descent ◽  
Allele Positivity

Abstract Objective To evaluate the frequency of HLA class I and II alleles associated with traditional forms of inflammatory arthritis in patients with immune checkpoint inhibitor (ICI)-induced inflammatory arthritis as compared with population controls. Methods High-resolution HLA typing was performed on 27 patients with ICI-induced inflammatory arthritis and 726 healthy controls. Genotyping at the shared epitope (SE) locus (HLA DRB1) was performed on 220 RA cases. Allele-positivity rates and frequency of having at least one SE allele were compared using Fisher’s exact test between ICI-induced inflammatory arthritis and healthy controls. Frequency of having at least one SE allele was also compared between ICI-induced inflammatory arthritis and RA cases. Results Twenty-six patients with ICI-induced inflammatory arthritis were of European descent, and one was African American. In those 26 patients, 16 (61.5%) had at least one SE allele, significantly different from healthy controls of European descent, in whom 299 (41.2%) had at least one SE allele (odds ratio 2.3, P = 0.04). The allele-positivity rate of DRB1*04: 05 was also higher in the ICI-induced inflammatory arthritis group. The ICI-induced inflammatory arthritis population and RA patients of European descent did not differ in frequency of having at least one SE allele, but ICI-induced inflammatory arthritis patients were more likely to be autoantibody-negative for RF and anti-CCP antibodies. Conclusion Patients with ICI-induced inflammatory arthritis of European descent were more likely to have at least one SE allele than healthy controls. Further studies are needed to validate these findings and investigate whether a unique immunogenetic framework increases risk for different immune-related adverse events.

Venous thromboembolism events in patients with advanced cancer on immune checkpoint inhibitors

Immunotherapy ◽  
2021 ◽  
Author(s):  
Adi Kartolo ◽  
Cynthia Yeung ◽  
Gordon T Moffat ◽  
Lilian Hanna ◽  
Wilma Hopman ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Advanced Cancer ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Checkpoint Inhibitors ◽  
Single Agent ◽  
Cancer Management ◽  
Thromboembolism Events

Aim: To evaluate the correlation between venous thromboembolism events (VTEs) and immune checkpoint inhibitor (ICI)-based regimens. Methods: This is a retrospective study of 403 patients with advanced cancer on ICI-based regimens. Results: We report 8% VTE incidence post-ICI initiation over a median of 11.1 months of follow-up. Compared with single-agent ICI, dual-ICI was significantly correlated with higher incidence of VTE (odds ratio [OR]: 4.196, 95% CI: 1.527–11.529, p = 0.005), but chemotherapy–immuno-oncology combination was not (OR: 1.374, 95% CI: 0.285–6.632, p = 0.693). Subsequent systemic therapy post-ICI was also independently associated with higher VTE incidence (OR: 2.599, 95% CI: 1.169–5.777, p = 0.019). Conclusion: Our findings suggest potential underreporting of VTE incidence in ICI clinical trials. As dual-ICI is becoming more prevalent in cancer management, clinicians should maintain vigilance regarding VTE in patients with advanced cancer on ICI-based regimens.

scholarly journals Case of nivolumab-induced sclerosing cholangitis: lessons from long-term follow-up

2020 ◽  
Vol 7 (1) ◽  
pp. e000487
Author(s):  
Tess McClure ◽  
Wanyuan Cui ◽  
Khashayar Asadi ◽  
Thomas John ◽  
Adam Testro
Keyword(s):  
Sclerosing Cholangitis ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Solid Organ ◽  
Long Term Outcomes ◽  
Durable Response ◽  
Long Term Follow Up ◽  
Proven Case

Nivolumab is an immune checkpoint inhibitor used to treat multiple solid-organ malignancies. While many of its immune-related adverse events are well established, nivolumab-induced sclerosing cholangitis remains poorly characterised, with no defined diagnostic criteria. Moreover, data regarding long-term outcomes are particularly lacking. We present a biopsy-proven case of nivolumab-induced sclerosing cholangitis, which uniquely captures 18 months of follow-up post-treatment. Our case highlights key features of intrahepatic subtype sclerosing cholangitis and suggests durable response to corticosteroid therapy.

Immunomodulatory treatment of immune checkpoint inhibitor-induced myocarditis: Pathway toward precision-based therapy

2020 ◽  
Vol 47 ◽  
pp. 107211 ◽  
Author(s):  
Dinu Valentin Balanescu ◽  
Teodora Donisan ◽  
Nicolas Palaskas ◽  
Juan Lopez-Mattei ◽  
Peter Y. Kim ◽  
...  
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Immunomodulatory Treatment

Hydroxychloroquine is a safe and effective steroid-sparing agent for immune checkpoint inhibitor–induced inflammatory arthritis

2019 ◽  
Vol 38 (5) ◽  
pp. 1513-1519 ◽  
Author(s):  
Janet Roberts ◽  
Michael Smylie ◽  
John Walker ◽  
Naveen S. Basappa ◽  
Quincy Chu ◽  
...  
Keyword(s):  
Immune Checkpoint ◽  
Inflammatory Arthritis ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Steroid Sparing

scholarly journals MLTI-03. FIRST-LINE STEREOTACTIC RADIOSURGERY COMBINED WITH SYSTEMIC TARGETED AND IMMUNE CHECKPOINT INHIBITOR THERAPY IN MELANOMA PATIENTS WITH NEWLY DIAGNOSED BRAIN METASTASES

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i14-i15
Author(s):  
Thatcher Heumann ◽  
Rebecca Ye ◽  
Peter Wu ◽  
Akram Habibi ◽  
Alexandra Sansosti ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Brain Metastases ◽  
Immune Checkpoint ◽  
Cumulative Incidence ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Newly Diagnosed ◽  
Comorbid Conditions ◽  
First Line

Abstract BACKGROUND: Of solid tumors, melanoma has the highest propensity for CNS spread with historic median survivals of 5–8 months following brain metastasis diagnosis. We evaluated the impact of systemic BRAF targeted and immune checkpoint inhibitor (ICI) therapies on survival outcomes in patients receiving stereotactic radiosurgery (SRS) for melanoma brain metastases (MBM) and assessed patient treatment burden associated with prolonged survival. METHODS: We retrospectively reviewed the demographics, disease characteristics, therapeutic regimens, overall survival, and first-year cumulative incidence of comorbid disease for patients with de novo MBM treated between 2013 and 2017 at a major melanoma referral center. RESULTS: Among 123 newly diagnosed MBM patients: 65% were male, 24% were 50 years old or less, 50% were BRAF mutated, 63% had multiple intracranial lesions at diagnosis. Locally, 73% received SRS as first-line treatment. Systemically, 73% received ICI, 46% received BRAF targeted therapy, and 12% received neither. With a median follow up of 11 months (mo), total cohort median OS was 13.2 mo. Median OS for first-line SRS combined with ICI and BRAF targeted therapy was 31.0 mo (47% 3-year OS), 17.5 mo (31% 3-year OS) with ICI monotherapy, and 6.1 mo (22% 3-yr OS) alone. SRS and BRAF targeted therapy were associated with improved OS. At one-year follow-up, comorbid conditions with the greatest cumulative incidence were fatigue, nausea, intracranial hemorrhage, deep vein thrombosis, major depressive disorder, and pneumonia. Patients averaged one inpatient visit every 4.5 mo (1 week average length of stay), and 2 advanced imaging studies (MR/CT/PET-CT) per month following MBM diagnosis. CONCLUSIONS: In one of the largest reported MBM series, survival has improved markedly for patients receiving first-line SRS combined with targeted and immunotherapies. Simultaneously, longer life expectancy comes with increasing incidences of comorbid conditions reflecting an evolving complexity of and need for coordination of care for patients with MBM.

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