Joint-Predominant Rheumatic Complications of Immune Checkpoint Inhibitor Therapy in Patients with Thymic Epithelial Tumors

Oncologist. 2022 Apr 5;27(4):e353-e356. doi: 10.1093/oncolo/oyac026.

Abstract

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced cancers. However, activation of the immune system can occasionally cause life-threatening toxicity involving critical organs. Induction of immune-mediated toxicity is a significant concern for patients with thymic epithelial tumors (TETs) due to defects in immune tolerance. An increased risk of skeletal and cardiac muscle inflammation following treatment with ICIs is well recognized in patients with advanced TETs. However, uncommon musculoskeletal and rheumatic complications can also occur. The cases presented in this report highlight the spectrum of presentation of immune-mediated, joint-predominant musculoskeletal adverse events in patients with advanced TETs treated with ICIs, including polymyalgia rheumatica-like illness and inflammatory arthritis.

Keywords: immunotherapy; inflammatory arthritis; myositis; polymyalgia rheumatica; thymic epithelial tumors.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Humans
  • Immune Checkpoint Inhibitors
  • Immunotherapy / adverse effects
  • Myositis* / chemically induced
  • Neoplasms* / drug therapy
  • Neoplasms, Glandular and Epithelial* / drug therapy
  • Polymyalgia Rheumatica* / drug therapy
  • Polymyalgia Rheumatica* / etiology
  • Thymus Neoplasms* / drug therapy

Substances

  • Immune Checkpoint Inhibitors