Pembrolizumab Therapy Triggering an Exacerbation of Preexisting Autoimmune Disease: A Report of 2 Patient Cases.
Sneha Phadke,Ramez Ghabour,Brian L. Swick,Andrea Swenson,Mohammed M. Milhem,Yousef Zakharia +5 more
TLDR
Whether this autoimmune activation is associated with a clinical response to therapy has been debated, and while not definitive, there is evidence in the literature of a possible association.Abstract:
Historically, metastatic melanoma was uniformly and rapidly lethal, and treatment options were limited. In recent years, however, checkpoint inhibitors have emerged as an accepted standard treatment for patients with advanced melanoma. In clinical trials, these agents have been largely well tolerated and have the potential to result in durable responses. Importantly though, one must recognize the unique side effect profile of these therapies, which can trigger or exacerbate underlying autoimmune disease. Whether this autoimmune activation is associated with a clinical response to therapy has been debated, and while not definitive, there is evidence in the literature of a possible association. The 2 cases presented describe this autoimmune phenomenon, along with a review of the existing literature on the relationship between response to immunotherapy and autoimmune side effects.read more
Citations
More filters
Journal ArticleDOI
Use of immune checkpoint inhibitors in the treatment of patients with cancer and preexisting autoimmune disease: A systematic review
TL;DR: A systematic review of all reported cases describing the use of CPIs in patients with cancer and preexisting autoimmune disease to summarize the evidence on adverse events associated with CPI therapy provides a synthesis of current evidence to aid in clinical decision making and planning of future studies in this population.
Journal ArticleDOI
Myasthenia gravis: An emerging toxicity of immune checkpoint inhibitors.
TL;DR: A new case of pembrolizumab-induced MG is presented and insights are provided into the underlying mechanisms of action of this phenomenon, which emphasises the importance of early recognition and robust treatment of this toxicity.
Journal ArticleDOI
Neurological toxicities associated with immune-checkpoint inhibitors.
TL;DR: ICI-associated irAEs constitute a new group of neurologic complications of systemic anticancer therapies, although potentially severe, these rare neurologic toxicities are often responsive to immune-modulating therapies.
Journal ArticleDOI
Neuromuscular adverse events associated with anti-PD-1 monoclonal antibodies: Systematic review.
TL;DR: Mortality was high in patients treated with nivolumab or pembrolizumab monotherapy or concurrent with other immunologic agents, such as ipilimumab, despite adequate treatment strategies including corticosteroid, IV immunoglobulins, and plasma exchange.
Journal ArticleDOI
Clinical features, predictive correlates, and pathophysiology of immune-related adverse events in immune checkpoint inhibitor treatments in cancer: a short review.
TL;DR: The possibility that two distinct pathways may be contributing to the phenomenon of irAEs within this class of drugs is explored, and the role that this might play in future research and clinical practice is explored.
References
More filters
Journal ArticleDOI
Safety and Activity of Anti–PD-L1 Antibody in Patients with Advanced Cancer
Julie R. Brahmer,Scott S. Tykodi,Scott S. Tykodi,Laura Q.M. Chow,Wen-Jen Hwu,Suzanne L. Topalian,Patrick Hwu,Charles G. Drake,Luis H. Camacho,John S. Kauh,Kunle Odunsi,Henry C. Pitot,Omid Hamid,Shailender Bhatia,Renato G. Martins,Keith D. Eaton,Shuming Chen,Theresa M. Salay,Suresh Alaparthy,Joseph F. Grosso,Alan J. Korman,Susan M. Parker,Shruti Agrawal,Stacie M. Goldberg,Drew M. Pardoll,Ashok Kumar Gupta,Jon M. Wigginton +26 more
TL;DR: Antibody-mediated blockade of PD-L1 induced durable tumor regression and prolonged stabilization of disease in patients with advanced cancers, including non-small-cell lung cancer, melanoma, and renal-cell cancer.
Journal ArticleDOI
Immune Checkpoint Blockade in Cancer Therapy
TL;DR: Concluding remarks are made that principles learned during the development of CTLA-4 and PD-1/PD-L1 approaches will likely be used as new immunologic checkpoint blocking antibodies begin clinical investigation, and whether they enhance the efficacy of either approach alone is investigated.
Journal ArticleDOI
Mechanism-driven biomarkers to guide immune checkpoint blockade in cancer therapy
TL;DR: This work discusses biomarkers for anti-PD1 therapy based on immunological, genetic and virological criteria and suggests mechanism-based insights from such studies may guide the design of synergistic treatment combinations based on immune checkpoint blockade.
Journal ArticleDOI
High-Dose Recombinant Interleukin 2 Therapy for Patients With Metastatic Melanoma: Analysis of 270 Patients Treated Between 1985 and 1993
Michael B. Atkins,Michael T. Lotze,Janice P. Dutcher,Richard I. Fisher,Geoffrey R. Weiss,Kim Margolin,Jeff Abrams,M. Sznol,David Parkinson,Michael Hawkins,Carolyn Paradise,Lori Kunkel,Steven A. Rosenberg +12 more
TL;DR: High-dose IL-2 treatment seems to benefit some patients with metastatic melanoma by producing durable CRs or PRs and should be considered for appropriately selected melanoma patients.
Journal ArticleDOI
Treatment of 283 Consecutive Patients With Metastatic Melanoma or Renal Cell Cancer Using High-Dose Bolus Interleukin 2
Steven A. Rosenberg,James Chih-Hsin Yang,Suzanne L. Topalian,Douglas J. Schwartzentruber,Jeffrey S. Weber,David R. Parkinson,Claudia A. Seipp,Jan Einhorn,Donald E. White +8 more
TL;DR: Because IL-2 does not have a direct effect on cancer cells but rather mediates its antitumor activity by altering host immune reactions, these data represent the best available evidence that immunologic therapy for cancer can be effective in selected patients.
Related Papers (5)
Exacerbation of myasthenia gravis in a patient with melanoma treated with pembrolizumab.
Myasthenia gravis associated with ipilimumab and nivolumab in the treatment of small cell lung cancer.
Neurological, respiratory, musculoskeletal, cardiac and ocular side-effects of anti-PD-1 therapy.
Lisa Zimmer,Simone M. Goldinger,Lars Hofmann,Carmen Loquai,Selma Ugurel,Ioannis Thomas,Maria I. Schmidgen,Ralf Gutzmer,Jochen Utikal,Daniela Göppner,Jessica C. Hassel,Friedegund Meier,Julia K. Tietze,Andrea Forschner,Carsten Weishaupt,Martin Leverkus,Renate Ursula Wahl,Ursula Dietrich,Claus Garbe,Michael C. Kirchberger,Thomas Eigentler,Carola Berking,Anja Gesierich,Angela M. Krackhardt,Dirk Schadendorf,Gerold Schuler,Reinhard Dummer,Lucie Heinzerling +27 more