Pathogenesis and clinical management of cancer-associated dermatomyositis

doi:10.3877/cma.j.issn.1674-0785.2025.08.007

Abstract

Abstract:

Cancer-associated dermatomyositis (CADM) is a paraneoplastic syndrome highly associated with tumors, and its early identification is crucial for the diagnosis and treatment of malignant tumors. This article systematically reviews the latest progress in the pathogenesis and clinical management of CADM. At the mechanistic level, it focuses on the central role of tumor antigen-driven autoimmune responses, along with the synergistic effects of inflammatory factor cascades, genetic susceptibility, and "inflammatory aging" in the tumor microenvironment. From a clinical perspective, a risk-stratified screening strategy based on antibody profiles and clinical characteristics is proposed. The therapeutic efficacy and safety of immunosuppressants and biologics in patients with concurrent tumors are discussed, as well as the impact of anti-tumor treatment on the improvement of dermatomyositis symptoms. Furthermore, this article highlights the significance of the multidisciplinary team model in disease management, examines prognostic influencing factors, identifies current controversies such as the cost-effectiveness of screening and the safety of targeted therapy, and offers an evidence-based foundation to inform clinical practice.

Key words: Malignant tumor, Dermatomyositis, Paraneoplastic syndrome, TIF1-γ antibody, Risk stratification screening, Multidisciplinary collaboration

Jianfeng Zhang, Hongqing Ma, Xueliang Wu, Ganlin Guo, Zesong Meng, Jun Feng, Zeming Zhao, Guiying Wang. Pathogenesis and clinical management of cancer-associated dermatomyositis[J]. Chinese Journal of Clinicians(Electronic Edition), 2025, 19(08): 601-605.

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