Abstract 14600: Pre-existing Autoimmune Disease and the Risk for Cardiovascular and Non-cardiovascular Immune Mediated Adverse Events With Immune Checkpoint Inhibitors

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Charlotte Lee ◽  
Zsofia D Drobni ◽  
Amna Zafar ◽  
Raza M Alvi ◽  
Sean P Murphy ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Autoimmune Disease ◽  
Adverse Events ◽  
Immune Checkpoint ◽  
Cardiovascular Events ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Skin Toxicity ◽  
Significant Difference

Introduction: The use of immune checkpoint inhibitors (ICIs) is associated with an increase in cardiovascular events. The mechanism is likely related to immune activation and inflammation. Patients with pre-existing autoimmune disease have a baseline increased risk for cardiovascular disease and have been traditionally excluded from clinical trials of ICIs. There is limited data on the cardiovascular and non-cardiovascular safety of ICIs in these patients. Methods: This was a retrospective study of 2845 patients treated with an ICI at the Massachusetts General Hospital. This cohort was screened by individual chart review for patients with a diagnosis of an autoimmune disease prior to ICI therapy. These autoimmune patients were compared to controls at a 1:2 ratio. Baseline characteristics and risk of cardiovascular and non-cardiovascular immune related adverse events (iRAEs) were compared. Cardiovascular events were a composite of myocardial infarction (MI), percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), stroke, transient ischemic attack (TIA), deep venous thrombosis (DVT), pulmonary embolism (PE), or myocarditis. Results: 93 patients had a diagnosis of an autoimmune disease prior to ICI. These patients were more likely to be older and to have a history of coronary artery disease, heart failure, chronic kidney disease, hypertension and diabetes mellitus. There were 12 events over a median follow-up period of 300 days. There was no significant difference in composite of cardiovascular events in follow-up (13 vs. 9.1%, autoimmune vs. none, P =0.41). The individual cardiovascular event rates were as follows: MI (4.3 vs. 0.5%, P =0.04), PCI (0 vs. 0.5%, P =1), CABG (0. vs. 0.5%, P =1), stroke (0 vs. 0%), TIA (0 vs. 0.5%, P =1), DVT (5.4 vs. 2.2%, P =0.17), PE (1.1 vs. 4.8%, P =0.17), and myocarditis (2.2 vs. 1.1%, P =0.60). There was an increased rate of pneumonitis (14 vs. 4%, P <0.001) and skin toxicity (16 vs. 0%, P <0.001). Conclusions: Patients with pre-existing autoimmune disease treated with an ICI had a higher baseline cardiovascular risk but did not have a significant increase in cardiovascular events in an unadjusted analysis. These patients did, however, have an increased rate of pneumonitis and skin toxicity after ICI.

Potential role of serum proteome in predicting immune-related adverse events from immune checkpoint inhibitors in non-small cell lung cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21218-e21218
Author(s):  
Leeseul Kim ◽  
Young Kwang Chae ◽  
Chan Mi Jung ◽  
Emma Yu ◽  
Alice Daeun Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Adverse Events ◽  
Small Cell Lung Cancer ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Small Cell ◽  
Small Cell Lung ◽  
Significant Difference ◽  
Nsclc Patients

e21218 Background: Early recognition of immune-related adverse events (irAEs) of immune checkpoint inhibitors(ICI) is important. Circulating proteome reflects host response to diseases and is being explored as a marker for response to immunotherapy. We previously have reported that a serum-based proteomics test, Primary Immune Response (PIR) demonstrated a trend that PIR-sensitive patients are more likely to tolerate ICI treatment longer without developing irAEs in non-small cell lung cancer (NSCLC) patients. The VeriStrat test is another serum-based proteomic assay, which was reported to be predictive of survival outcomes for all treatment regimens and lines of therapy including ICI in NSCLC. We explored the associations between the VeriStrat test and developing irAEs in NSCLC patients treated with ICI. Methods: Data of 70 consented NSCLC patients treated with any regimens and lines of therapy including ICI were collected. Samples were grouped into either VeriStrat ‘Good’(VS-G) or VeriStrat ‘Poor’(VS-P). We analyzed the durations from the immunotherapy initiation to each episode of irAE and each irAE above grade 2 using log-rank test. IrAEs were graded according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Results: Among the 70 patients, 18 patients (25%) experienced one or more irAEs. There was no significant difference in ‘Time to first irAE’ between VS-G and VS-P (p = 0.72, HR = 0.82, 95% CI = 0.29-2.32). Among 48 VS-G patients, 12(25%) had one or more irAE and 5(10%)had irAE graded over 2. Among 22 VS-P patients, 6(27%) had one or more irAE and 2(9%) had irAE graded over 2. There was no significant difference between VS-G and VS-P groups in the development of irAE and irAE graded over 2. Conclusions: There was no statistically significant association between the VeriStrat test and the development of irAEs. Further studies are warranted to investigate proper serum based proteomic assay to predict the development of irAE.

scholarly journals Correlation between immune-related adverse events and prognosis in patients with gastric cancer treated with nivolumab

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ken Masuda ◽  
Hirokazu Shoji ◽  
Kengo Nagashima ◽  
Shun Yamamoto ◽  
Masashi Ishikawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adverse Events ◽  
Immune Checkpoint ◽  
Clinical Benefit ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Progression Free Survival ◽  
Motor Neuropathy ◽  
Metastatic Sites

Abstract Background Recent studies have shown that immune-related adverse events (irAEs) caused by immune checkpoint inhibitors were associated with clinical benefit in patients with melanoma or lung cancer. In advanced gastric cancer (AGC) patients, there have been few reports about the correlation between irAEs and efficacy of immune checkpoint inhibitors. In this study, we retrospectively investigated the correlation between irAEs and efficacy in AGC patients treated with nivolumab. Methods The subjects of this study were AGC patients received nivolumab monotherapy between January 2015 and August 2018. IrAEs were defined as those AEs having a potential immunological basis that required close follow-up, or immunosuppressive therapy and/or endocrine therapy. We divided the patients who received nivolumab into two groups based on occurrence of irAEs; those with irAEs (irAE group) or those without (non-irAE group). We assessed the efficacy in both groups. Results Of the 65 AGC patients that received nivolumab monotherapy, 14 developed irAEs. The median time to onset of irAEs was 30.5 days (range 3–407 days). Median follow-up period for survivors was 32 months (95% CI, 10.8 to 34.5). The median progression-free survival was 7.5 months (95% CI, 3.6 to 11.5) in the irAE group and 1.4 months (95% CI, 1.2 to 1.6) in the non-irAE group (HR = 0.11, p < 0.001). The median overall survival was 16.8 months (95% CI, 4.4 to not reached) in the irAE group and 3.2 months (95% CI, 2.2 to 4.1) in the non-irAE group (HR = 0.17, p < 0.001). Multivariate analysis demonstrated that number of metastatic sites ≥2 (HR = 2.15; 95% CI, 1.02 to 4.54), high ALP level (HR = 2.50; 95% CI, 1.27 to 4.54), and absence of irAEs (HR = 9.54, 95% CI, 3.34 to 27.30 for yes vs. no) were associated with a poor prognosis. The most frequent irAEs was diarrhea/colitis (n = 5). Grade 3 adverse events were observed in 6 patients; hyperglycemia (n = 2), diarrhea/colitis (n = 1), adrenal insufficiency (n = 1), aspartate aminotransferase increased (n = 1), peripheral motor neuropathy (n = 1). There were no grade 4 or 5 adverse events related to nivolumab. Conclusions Development of irAEs was associated with clinical benefit for AGC patients receiving nivolumab monotherapy.

Prognosis of patients developing immune-related adverse events with immune checkpoint inhibitors in melanoma influenced by the ability to resume therapy.

2020 ◽  
Vol 38 (5_suppl) ◽  
pp. 61-61
Author(s):  
Jung Min Song ◽  
Tapas Ranjan Behera ◽  
Kathryn Demski ◽  
Ann Yurco ◽  
Pradnya Dinkar Patil ◽  
...  
Keyword(s):  
Adverse Events ◽  
Disease Progression ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Tumor Board ◽  
The Face ◽  
Cancer Outcome ◽  
Grade 3

61 Background: Immune checkpoint inhibitors (ICPis) have improved survival in melanoma patients, however their use is associated with 5-60% patients experiencing severe immune related adverse events (irAEs). Severe irAEs may affect survival benefit imparted by ICPis. Objective: We aimed to analyze disease outcomes with resumption of immunotherapy as compared to non-resumption of immunotherapy in patients with severe irAEs (Grade 3/4 in CTCAE v5.0). Methods: Patients with melanoma being treated with ICPis who developed severe irAEs were discussed in an institutional irAE tumor board (TB). We analyzed all patients discussed in TB from September 2017 to September 2019 for cancer outcome of withholding versus resuming immunotherapy in the face of severe irAEs. Results: Out of 26 total patients with melanoma discussed in TB, 23 had severe irAE. Colitis was the most common irAE 9/23 (39.1%) followed by 2/23 (8.7%) of pneumonitis and hepatitis each. ICPi was resumed in 8 patients (resume group) (median age 53, range 42-67) and withheld in 15 patients (non-resume group) (median age 57, range 42-91). In the resume group all 8 patients (100%) are alive, of which 2/8 (25%) had disease progression (median follow up 106.5wk, range 35wk-131wk); whereas, in the non-resume group 9/15 (60%) progressed, of which 6/15 (40%) died (median follow up 91wk, range 3wk-197wk). Conclusions: Our data suggest that the ability to resume ICPi after an episode of severe irAE is associated with better prognosis in terms of disease progression and survival. Immunotherapy being the mainstay of the management in metastatic melanoma, inability to resume therapy is associated with worse prognosis. Timely management of irAEs should be prioritized in order to resume treatment.

scholarly journals 625 COVID-19 vaccination in patients with renal cancer or melanoma receiving immune checkpoint inhibitors

2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A655-A655
Author(s):  
Joyce Hwang ◽  
Hannah Dzimitrowicz ◽  
Riddhishkumar Shah ◽  
Kathleen Ashcraft ◽  
Daniel George ◽  
...  
Keyword(s):  
Adverse Events ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Control Group ◽  
Post Vaccination ◽  
Safety And Efficacy ◽  
Patients With Cancer

BackgroundPatients with cancer are at high risk for severe COVID-19 disease and mortality1; however, patients on active cancer treatment, including immune checkpoint inhibitors (ICI), were excluded from COVID19 vaccine trials.2 3 Thus, safety and efficacy of COVID-19 vaccination in patients receiving ICIs is not well described.MethodsWe identified patients with renal cell carcinoma (RCC) or melanoma who received at least one dose of an FDA-authorized COVID-19 vaccine (vax+), with or without being on ICI, between the dates of December 1, 2020 and April 1, 2021, and had at least 3 months of documented follow up at Duke Cancer Center. Retrospective chart abstraction of patient encounters during three months following vaccination was performed. Patient characteristics included demographics and oncologic treatments. Primary outcome was adverse events attributed to vaccination; other outcomes included immune related adverse events (IRAE) following vaccination and subsequent COVID-19 infection.Results51 study patients (vax+ with ICI) and 23 control patients (vax+ not on active treatment) were initially identified. Baseline characteristics are in table 1. 27.5% of ICI patients (N = 14/51) reported symptoms attributed to vaccination. Common symptoms reported by the ICI group were fever (9.8%; N = 5), chills (7.8%; N = 4), arm pain (7.8%; N = 4), myalgias (7.8%; N = 4), lymphadenopathy (7.8%; N = 4), headache (5.9%; N = 3), and diarrhea (3.9%; N = 2). None of these were reported in the control group. One patient in the ICI group developed a rash at the injection site, and one developed porokeratoses following the second dose. From the control group, one patient developed a stye and one patient developed PVCs. Five ICI patients (9.8%) developed a new or worsening IRAE requiring systemic steroids and/or treatment hold. These IRAEs included: colitis (N = 2), hepatitis, rash, and concurrent pancreatitis/colitis. Two ICI patients (4%) and 0 patients developed COVID-19 infection after one and two vaccine doses, respectively.ConclusionsAmongst a heterogeneous population of patients receiving ICI therapy, COVID-19 vaccination appears to be well tolerated and safe. The higher rate of symptoms reported post-vaccination in patients receiving ICI therapy is likely related to more frequent follow up intervals versus control. The rate of new or worsening IRAEs post-vaccination is no higher than historically reported.4 5 An update of this data with a larger cohort will be presented. Larger cohort studies of patients receiving ICIs are needed to fully assess the safety and efficacy of COVID-19 vaccination in this population; however, these data support the safety of vaccination in patients receiving ICIs.ReferencesKuderer NM, Choueiri TK, Shah DP, Shyr Y, Rubinstein SM, Rivera DR et al. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. The Lancet 2020;395:1907–1918.Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med 2020;383(27):2603–15.Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 Vaccine. N Engl J Med 2020.Xing P, Zhang F, Wang G, Xu Y, Li C, Wang S, et al. Incidence rates of immune-related adverse events and their correlation with response in advanced solid tumors treated with NIVO or NIVO+IPI: a systematic review and meta-analysis. J ImmunoTherapy Cancer 2019;341.Osta B, Hu F, Sadek R, Chintalapally R, Tang S. A meta-analysis of immune-related adverse events of immune checkpoint inhibitors from cancer clinical trials. Submitted Abstracts Immunotherapy of Cancer 2016;27.Abstract 625 Table 1Baseline characteristics of ICI and control populations

scholarly journals Cutaneous Adverse Events of Immune Checkpoint Inhibitors: A Literature Review

2021 ◽  
pp. e2021155
Author(s):  
Zoe Apalla ◽  
Chryssoula Papageorgiou ◽  
Aimilios Lallas ◽  
Florentina Delli ◽  
Christina Fotiadou ◽  
...  
Keyword(s):  
Adverse Events ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Early Recognition ◽  
Skin Toxicity ◽  
Immune Checkpoint Blockade ◽  
Self Tolerance ◽  
Oncologic Patients ◽  
Dose Modifications

Immune checkpoint inhibitors (CPIs) are targeted molecules that modulate the immune system, assist with self-tolerance, and minimize collateral tissue damage when immune responses are activated. Although they are characterized by a favorable risk/benefit ratio, immune checkpoint blockade has been associated with a new subset of autoimmune-like toxicities, named immune-related adverse events (irAE). Dermatologic reactions are among the most prevalent irAE triggered by CPIs. In a majority of cases they are self-limiting and readily manageable. However, it is not uncommon that they result in severe skin involvement and impairment of patients’ quality of life. Awareness of the spectrum of cutaneous irAEs is mandatory for every clinician involved in the management of oncologic patients. The role of the dermatologists is essential because early recognition and appropriate management of skin toxicity may prevent dose modifications and discontinuation of CPIs. The latter is particularly relevant, considering that recent data suggest favorable oncologic response in patients developing irAEs.  

Correlation between immune-related adverse events and prognosis in patients with gastric cancer treated with nivolumab.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 4049-4049 ◽  
Author(s):  
Ken Masuda ◽  
Hirokazu Shoji ◽  
Kengo Nagashima ◽  
Shun Yamamoto ◽  
Masashi Ishikawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adverse Events ◽  
Immune Checkpoint ◽  
Clinical Benefit ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Progression Free Survival ◽  
Motor Neuropathy ◽  
Progression Of Disease

4049 Background: Recent studies have shown that immune-related adverse events (irAEs) caused by immune checkpoint inhibitors were associated with clinical benefit in patients with melanoma or lung cancer. In advanced gastric cancer (AGC) patients, there have been few reports about the correlation between irAEs and efficacy of immune checkpoint inhibitors. Therefore, in this study, we retrospectively investigated the correlation between irAEs and efficacy in AGC patients treated with nivolumab. Methods: The subjects of this study were AGC patients that had received nivolumab monotherapy between January 2015 and August 2018. IrAEs were defined as those AEs having a potential immunological basis that required close follow-up, or immunosuppressive therapy and/or endocrine therapy. We divided the patients who received nivolumab into two groups based on occurrence of irAEs; those with irAEs (irAE group) or those without (non-irAE group). We assessed the efficacy in both groups. Results: Of the 65 AGC patients that received nivolumab monotherapy, 14 developed irAEs. The median time to onset of irAEs was 30.5 days (range 3–407 days). Median follow-up period for survivors was 32 months (95% CI, 10.8 to 34.5). The median progression-free survival was 7.5 months (95% CI, 3.6 to 11.5) in the irAE group and 1.4 months (95% CI, 1.2 to 1.6) in the non-irAE group (HR = 0.11, p < 0.001). The median overall survival was 16.8 months (95% CI, 4.4 to not reached) in the irAE group and 3.2 months (95% CI, 2.2 to 4.1) in the non-irAE group (HR = 0.17, p < 0.001). Multivariate analysis demonstrated that high ALP level (HR = 2.88; 95% CI, 1.51 to 5.51) and absence of irAEs (HR = 3.06, 95% CI, 3.06 to 23.46 for yes vs. no) were associated with a poor prognosis. The most frequent irAEs was diarrhea/colitis (n = 5). Grade 3 adverse events were observed in 6 patients; hyperglycemia (n = 2), diarrhea/colitis (n = 1), adrenal insufficiency (n = 1), increased aspartate aminotransferase increased (n = 1), peripheral motor neuropathy (n = 1). One of the 14 patients experienced the irAE after discontinuation of nivolumab due to progression of disease. There were no grade 4 or 5 adverse events related to nivolumab. Conclusions: Development of irAEs was associated with clinical benefit for AGC patients receiving nivolumab monotherapy.

scholarly journals Safety and Efficacy of the Rechallenge of Immune Checkpoint Inhibitors After Immune-Related Adverse Events in Patients With Cancer: A Systemic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Qing Zhao ◽  
Jianwei Zhang ◽  
Lingyi Xu ◽  
Huaxia Yang ◽  
Naixin Liang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Systemic Review ◽  
High Grade ◽  
Safety And Efficacy ◽  
Patients With Cancer ◽  
Significant Difference

IntroductionLittle evidence exists on the safety and efficacy of the rechallenge of immune checkpoint inhibitors (ICIs) after immune-related adverse events (irAEs) in patients with cancer.MethodsWe searched PubMed, Web of Science, Embase, and Cochrane for articles on ICI rechallenge after irAEs for systemic review and meta-analysis. The outcomes included the incidence and associated factors for safety and objective response rate (ORR) and disease control rate (DCR) for efficacy.ResultsA total of 789 ICI rechallenge cases from 18 cohort studies, 5 case series studies, and 54 case reports were included. The pooled incidence of all-grade and high-grade irAEs after rechallenge in patients with cancer was 34.2% and 11.7%, respectively. Compared with initial ICI treatment, rechallenge showed a higher incidence for all-grade irAEs (OR, 3.81; 95% CI, 2.15–6.74; p &lt; 0.0001), but similar incidence for high-grade irAEs (p &gt; 0.05). Types of initial irAEs (pneumonitis and global irAEs) and cancer (non-small cell lung cancer and multiple cancer) recapitulated these findings. Gastrointestinal irAEs and time interval between initial irAEs and ICI rechallenge were associated with higher recurrence of high-grade irAEs (p &lt; 0.05), whereas initial anti-PD-1/PD-L1 antibodies were associated with a lower recurrence (p &lt; 0.05). Anti-PD-1/PD-L1 antibodies rechallenge was associated with a lower all-grade irAE recurrence (p &lt; 0.05). The pooled ORR and DCR after rechallenge were 43.1% and 71.9%, respectively, showing no significant difference compared with initial ICI treatment (p &gt; 0.05).ConclusionsICI rechallenge after irAEs showed lower safety and similar efficacy outcomes compared with initial ICI treatment.Systematic Review RegistrationPROSPERO, identifier CRD42020191405.

scholarly journals FRI0494 RHEUMATIC IMMUNE RELATED ADVERSE EVENTS OF CHECKPOINT INHIBITORS: A RETROSPECTIVE REVIEW OF 70 PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 845.2-846
Author(s):  
T. Lenfant ◽  
L. Calabrese ◽  
C. Calabrese
Keyword(s):  
Adverse Events ◽  
Prospective Studies ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Clinical Aspects ◽  
Link Type ◽  
Conventional Dmards

Background:Immune Checkpoint inhibitors (ICI) have revolutionized cancer therapy by achieving remarkable survival benefits however, at the cost of a myriad of immune-related adverse events (irAEs)[1]. Rheumatic irAE can develop in 5-10% of patients although the true incidence is unknown given the lack of prospective studies [2]. Symptoms are heterogenous and probably underreported with few data available about their management and outcome [3].Objectives:To describe the clinical, biological, and radiological features of the largest cohort of rheumatic irAEs from ICI along with their therapeutic management, outcome and follow-up in real-world practice.Methods:A referral process for emergent rheumatic irAEs was initiated in February 2016 between the oncology and rheumatology departments at the Cleveland Clinic Foundation. All patients were evaluated by authors CC and/or LHC. Patients’ characteristics were retrospectively collected from medical charts after IRB approval.Results:70 patients referred for one or more rheumatic irAEs between February 2016 and January 2020 were included. 66% were male, median age was 60.8 years. Among them, 24 (34%) had pre-existing rheumatic complaints. Melanoma was the most frequent malignancy (56%). ICI therapy included anti-CTLA4 (40%), anti-PD1/L1 (79%), and dual therapy ipilimumab/nivolumab (41%). Rheumatic irAE occurred in a median 4 months after ICI initiation, with phenotypes including inflammatory arthritis (32 patients), sicca-like symptoms (12), polymyalgia rheumatica-like (7), and myositis (2). Oral, intravenous or intraarticular glucocorticoids (GC) were administered to 54 patients (77%). Of these 54 patients, 22 (41%) required long term GC, 19 had bone density scan and 15 received pneumocystis (PJP) prophylaxis. One PJP case, 1 osteoporotic fracture and 2 avascular necrosis cases were reported. 16 patients received conventional DMARDS (23%) and 9 received biologics (13%). ICI therapy was held for rheumatic irAE in 31% of cases and for another systemic irAE in 29%. Median follow-up was 13.6 months, at end of follow-up 51 patients were still on treatment for rheumatic irAE and 41% of them were still symptomatic despite ongoing treatment.Conclusion:Rheumatic irAEs are heterogeneous and often chronic requiring prolonged immunomodulatory therapy. Prospective studies are required to define optimal management of rheumatic irAEs that maintain long-term oncologic outcomes.References:[1]Suarez-Almazor ME, Kim ST, Abdel-Wahab N, Diab A. Review: Immune-Related Adverse Events With Use of Checkpoint Inhibitors for Immunotherapy of Cancer. Arthritis Rheumatol 2017;69:687–99.https://doi.org/10.1002/art.40043.[2]Abdel-Wahab N, Suarez-Almazor ME. Frequency and distribution of various rheumatic disorders associated with checkpoint inhibitor therapy. Rheumatol (United Kingdom) 2019;58:vii40–8.https://doi.org/10.1093/rheumatology/kez297.[3]Kostine M, Rouxel L, Barnetche T, Veillon R, Martin F, Dutriaux C, et al. Rheumatic disorders associated with immune checkpoint inhibitors in patients with cancer-clinical aspects and relationship with tumour response: a single-centre prospective cohort study. Ann Rheum Dis 2018;77:393–8.https://doi.org/10.1136/annrheumdis-2017-212257.Disclosure of Interests:Tiphaine Lenfant: None declared, Leonard Calabrese Consultant of: AbbVie, GSK, Bristol-Myers Squibb, Genentech, Janssen, Novartis, Sanofi, Horizon, Crescendo, and Gilead, Speakers bureau: Sanofi, Horizon, Crescendo, Novartis, Genentech, Janssen, and AbbVie, cassandra calabrese Consultant of: AbbvieGSK, Speakers bureau: Sanofi-Genzyme

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