Immune checkpoint inhibitors in advanced cancer patients with pre-existing autoimmune diseases: challenges and prospects

doi:10.3877/cma.j.issn.1674-0785.2024.12.011

Abstract

Abstract:

Immune checkpoint inhibitors (ICIs) have achieved a milestone breakthrough in the field of advanced cancer treatment, greatly improving the overall prognosis of these patients. However, due to their potential to lead to the recurrence or exacerbation of autoimmune diseases (AIDs), almost all clinical trials involving ICIs have excluded malignant tumor patients with concurrent AIDs. Can patients in this specific group attempt ICI treatment? What are the risks and benefits of this treatment? This article will systematically summarize the current application status, challenges, and prospects of ICIs in tumor patients with pre-existing AIDs, aiming to provide comprehensive guidance for the use of ICIs in this special population to achieve favourable therapeutic effects.

Key words: Immune checkpoint inhibitors, Immune-related adverse events, Autoimmune diseases, Immunosuppressive therapy

Yong Fan, Yanjie Hao, Juan Zhao, Yan Geng, Zhuoli Zhang. Immune checkpoint inhibitors in advanced cancer patients with pre-existing autoimmune diseases: challenges and prospects[J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(12): 1146-1149.

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References 38

1	Arafat HM. A comprehensive review of immune checkpoint inhibitors for cancer treatment[J]. Int Immunopharmacol, 2024, 143(Pt 2):113365.
2	Butterfield LH, Najjar YG. Immunotherapy combination approaches:mechanisms, biomarkers and clinical observations[J]. Nat Rev Immunol, 2024, 24(6):399-416.
3	Xin Yu J, Hubbard-Lucey VM, Tang J. Immuno-oncology drug development goes global[J]. Nature Reviews Drug Discovery, 2019,18(12):899-900.
4	樊勇, 耿研, 赵娟, 等. 免疫检查点抑制剂相关风湿免疫病表现及管理[J]. 中国医学前沿杂志（电子版）, 2022, 14(8):6-10.
5	高君伟, 刘皋林. 自身免疫性疾病的药物治疗 [J/OL]. 中华临床医师杂志(电子版), 2023, 17(12): 1209-1211.
6	Fan Y, Geng Y, Shen L et al. Advances on immune-related adverse events associated with immune checkpoint inhibitors[J]. Frontiers of Medicine, 2021, 15(1):33-42.
7	Ramos-Casals M, Siso-Almirall A. Immune-Related Adverse Events of Immune Checkpoint Inhibitors[J]. Ann Intern Med, 2024,177(2):ITC17-ITC32.
8	Khan SA, Pruitt SL, Xuan L et al. Prevalence of Autoimmune Disease Among Patients With Lung Cancer[J]. JAMA Oncology, 2016,2(11):1507.
9	van der Kooij MK, Suijkerbuijk KPM, Aarts MJB et al. Safety and Efficacy of Checkpoint Inhibition in Patients With Melanoma and Preexisting Autoimmune Disease[J]. Annals of Internal Medicine,2021, 174(5):641-648.
10	Menzies AM, Johnson DB, Ramanujam S et al. Anti-PD-1 therapy in patients with advanced melanoma and preexisting autoimmune disorders or major toxicity with ipilimumab[J]. Annals of Oncology,2017, 28(2):368-376.
11	Abdel-Wahab N, Shah M, Lopez-Olivo MA et al. Use of Immune Checkpoint Inhibitors in the Treatment of Patients With Cancer and Preexisting Autoimmune Disease[J]. Annals of Internal Medicine,2018, 168(2):121.
12	Danlos F, Voisin A, Dyevre V et al. Safety and efficacy of antiprogrammed death 1 antibodies in patients with cancer and preexisting autoimmune or inflammatory disease[J]. European Journal of Cancer, 2018, 91:21-29.
13	Leonardi GC, Gainor JF, Altan M et al. Safety of Programmed Death-1 Pathway Inhibitors Among Patients With Non-Small-Cell Lung Cancer and Preexisting Autoimmune Disorders[J]. J Clin Oncol, 2018,36(19):1905-1912.
14	Tison A, Quéré G, Misery L, et al. Safety and Efficacy of Immune Checkpoint Inhibitors in Patients With Cancer and Preexisting Autoimmune Disease: A Nationwide, Multicenter Cohort Study[J].Arthritis & Rheumatology, 2019, 71(12):2100-2111.
15	Abu-Sbeih H, Faleck DM, Ricciuti B, et al. Immune Checkpoint Inhibitor Therapy in Patients With Preexisting Inflammatory Bowel Disease [J]. Journal of Clinical Oncology, 2020, 38(6):576-583.
16	Lopez-Olivo MA, Kachira JJ, Abdel-Wahab N et al. A systematic review and meta-analysis of observational studies and uncontrolled trials reporting on the use of checkpoint blockers in patients with cancer and pre-existing autoimmune disease[J]. Eur J Cancer, 2024,207:114148.
17	Rzeniewicz K, Larkin J, Menzies AM et al. Immunotherapy use outside clinical trial populations: never say never?[J]. Ann Oncol,2021, 32(7):866-880.
18	Liu X, Li S, Ke L, et al. Immune checkpoint inhibitors in Cancer patients with rheumatologic preexisting autoimmune diseases:a systematic review and meta-analysis[J]. BMC Cancer, 2024,24(1):490.
19	Tang H, Zhou J, Bai C. The efficacy and safety of immune checkpoint inhibitors in patients with cancer and preexisting autoimmune disease[J]. Frontiers in Oncology, 2021, 11: 625872.
20	Reid P, Sandigursky S, Song J et al. Safety and effectiveness of combination versus monotherapy with immune checkpoint inhibitors in patients with preexisting autoimmune diseases[J]. Oncoimmunology,2023, 12(1):2261264.
21	Thompson JA, Schneider BJ, Brahmer J et al. NCCN Guidelines(R)Insights: Management of Immunotherapy-Related Toxicities, Version 2.2024[J]. J Natl Compr Canc Netw, 2024, 22(9):582-592.
22	Arbour KC, Mezquita L, Long N et al. Impact of Baseline Steroids on Efficacy of Programmed Cell Death-1 and Programmed Death-Ligand 1 Blockade in Patients With Non-Small-Cell Lung Cancer[J]. Journal of Clinical Oncology, 2018, 36(28):2872-2878.
23	Ricciuti B, Dahlberg SE, Adeni A et al. Immune Checkpoint Inhibitor Outcomes for Patients With Non-Small-Cell Lung Cancer Receiving Baseline Corticosteroids for Palliative Versus Nonpalliative Indications[J]. Journal of Clinical Oncology, 2019, 37(22):1927-1934.
24	Bai X, Hu J, Betof Warner A et al. Early Use of High-Dose Glucocorticoid for the Management of irAE Is Associated with Poorer Survival in Patients with Advanced Melanoma Treated with Anti-PD-1 Monotherapy[J]. Clinical Cancer Research, 2021, 27(21):5993-6000.
25	Carbone DP, Reck M, Paz-Ares L et al. First-Line Nivolumab in Stage IV or Recurrent Non-Small-Cell Lung Cancer[J]. New England Journal of Medicine, 2017, 376(25):2415-2426.
26	Schneider BJ, Naidoo J, Santomasso BD et al. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update[J]. Journal of Clinical Oncology, 2021, 39(36):4073-4126.
27	Libert C, Dejager L. How Steroids Steer T Cells[J]. Cell Reports,2014, 7(4):938-939.
28	Gruver-Yates A, Cidlowski J. Tissue-Specific Actions of Glucocorticoids on Apoptosis: A Double-Edged Sword[J]. Cells, 2013,2(2):202-223.
29	Tokunaga A, Sugiyama D, Maeda Y et al. Selective inhibition of low-affinity memory CD8+ T cells by corticosteroids[J]. Journal of Experimental Medicine, 2019, 216(12):2701-2713.
30	Haanen J, Ernstoff MS, Wang Y et al. Autoimmune diseases and immune-checkpoint inhibitors for cancer therapy: review of the literature and personalized risk-based prevention strategy[J]. Ann Oncol, 2020, 31(6):724-744.
31	Frohne CC, Llano EM, Perkovic A et al. Complete response of metastatic melanoma in a patient with Crohn’s disease simultaneously receiving anti-α4β7 and anti-PD1 antibodies[J]. Journal for ImmunoTherapy of Cancer, 2019, 7(1):1.
32	Uemura M, Trinh VA, Haymaker C et al. Selective inhibition of autoimmune exacerbation while preserving the anti-tumor clinical benefit using IL-6 blockade in a patient with advanced melanoma and Crohn’s disease: a case report[J]. Journal of Hematology &Oncology, 2016, 9(1):81.
33	Martins F, Sykiotis GP, Maillard M et al. New therapeutic perspectives to manage refractory immune checkpoint-related toxicities[J]. The Lancet Oncology, 2019, 20(1):e54-e64.
34	Henderson BM, Del RS, Miller WH. Potential therapies for immunerelated adverse events associated with immune checkpoint inhibition:from monoclonal antibodies to kinase inhibition[J]. J Immunother Cancer, 2022, 10(1).
35	Rose N, Furer V, Polachek A et al. Immune Checkpoint Inhibitor-Induced Inflammatory Arthritis: Overview of Therapies and a Personalized Approach to Optimized Combined Therapy[J]. Eur J Rheumatol, 2024, 11(1):27-32.
36	Wang M, Chen S, He X et al. Targeting inflammation as cancer therapy[J]. J Hematol Oncol, 2024, 17(1):13.
37	Kang JH, Bluestone JA, Young A. Predicting and Preventing Immune Checkpoint Inhibitor Toxicity: Targeting Cytokines[J]. Trends in Immunology, 2021, 42(4):293-311.
38	Perez-Ruiz E, Minute L, Otano I et al. Prophylactic TNF blockade uncouples efficacy and toxicity in dual CTLA-4 and PD-1 immunotherapy[J]. Nature, 2019, 569(7756):428-432.

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