Musculoskeletal adverse reactions after immunotherapy for cancer: A case series.
cancer
immune checkpoint inhibitors
immunotherapy
musculoskeletal adverse events
rheumatology
Journal
Experimental and therapeutic medicine
ISSN: 1792-1015
Titre abrégé: Exp Ther Med
Pays: Greece
ID NLM: 101531947
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
10
05
2021
accepted:
09
06
2021
entrez:
10
8
2021
pubmed:
11
8
2021
medline:
11
8
2021
Statut:
ppublish
Résumé
Immunotherapy has revolutionized cancer treatment. Immune checkpoint inhibitors (ICIs) including antibodies targeting cytotoxic T lymphocyte associated antigen-4 and programmed cell death 1 have been shown to be effective in the treatment of certain types of cancer. The benefit of these therapies is to prolong life expectancy in the case of metastatic malignancies. Rheumatic adverse events are not very common. In the present study, 9 patients were monitored between November 2018 and January 2020. The oncologist, who identified the occurrence of rheumatic toxicities after the treatment with ICIs, evaluated the patients. Only oncological patients with rheumatic manifestations after the start of immunotherapy were included. Toxicity grading was performed by both the oncologist and the rheumatologist, on a scale from 1 to 5 (1, mild; 2, moderate; 3, severe; 4, life-threatening; 5, death related to toxicity). The results showed that rheumatoid factor, which was sampled in each patient, was negative in all cases. Patients were treated with nonsteroidal anti-inflammatory drugs or prednisone depending on the severity of the adverse events. The results varied with the severity of the adverse events. In conclusion, as the number of patients treated with ICIs increases, so will the number of patients presenting with immune-related adverse events (irAEs). The collaboration between oncologists and rheumatologists should be intimate to provide optimal treatment to patients. Musculoskeletal manifestations secondary to ICIs are slightly different from other rheumatologically conditions making diagnosis, treatment and monitoring difficult. Thus, irAEs are new and challenging for oncologists, thus understanding of the pathogenesis and clinical characteristics must be improved for better treatment guidelines.
Identifiants
pubmed: 34373713
doi: 10.3892/etm.2021.10459
pii: ETM-0-0-10459
pmc: PMC8343871
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1027Informations de copyright
Copyright: © Creţu et al.
Déclaration de conflit d'intérêts
The authors declare that they have no competing interests.
Références
Ann Rheum Dis. 2017 Jan;76(1):43-50
pubmed: 27307501
Eur J Cancer. 2019 Jan;106:12-23
pubmed: 30453170
J Clin Oncol. 2015 Jun 10;33(17):1974-82
pubmed: 25605845
FEBS Lett. 2014 Jan 21;588(2):368-76
pubmed: 24161671
Ann Oncol. 2017 Feb 1;28(2):368-376
pubmed: 27687304
Autoimmun Rev. 2018 Mar;17(3):284-289
pubmed: 29341936
N Engl J Med. 2018 Jan 11;378(2):158-168
pubmed: 29320654
Rheum Dis Clin North Am. 2017 Feb;43(1):65-78
pubmed: 27890174
Nat Rev Cancer. 2012 Mar 22;12(4):252-64
pubmed: 22437870
N Engl J Med. 2015 Jun 25;372(26):2521-32
pubmed: 25891173
Korean J Intern Med. 2019 Nov;34(6):1197-1209
pubmed: 31014065
Ann Oncol. 2017 Jul 1;28(suppl_4):iv119-iv142
pubmed: 28881921
RMD Open. 2017 Mar 20;3(1):e000412
pubmed: 28405474
J Immunother. 2005 Nov-Dec;28(6):593-8
pubmed: 16224277
Front Pharmacol. 2017 Feb 08;8:49
pubmed: 28228726
Br J Cancer. 2018 Jan;118(1):9-16
pubmed: 29319049
Bull NYU Hosp Jt Dis. 2012;70(2):109-14
pubmed: 22892000