Cancer immunotherapy in patients with preexisting autoimmune disorders

Semin Immunopathol. 2017 Apr;39(3):333-337. doi: 10.1007/s00281-016-0595-8. Epub 2016 Oct 11.

Abstract

Patients with preexisting active autoimmune disorders were excluded from clinical trials of immune checkpoint inhibitors. However, patients with autoimmune disorders are diagnosed with cancer at least as frequently as the global population, and clinicians treating patients outside clinical trials have generally been reluctant to offer cancer immunotherapy to this patient group. In this brief article, we review the most recent literature on the efficacy and safety of CTLA-4- and PD-1-blocking antibodies in patients with preexisting autoimmune disorders.

Keywords: Autoimmune diseases; Autoimmune disorders; CTLA-4; Cancer immunotherapy; Checkpoint inhibitors; Immunotherapy; Ipilimumab; Melanoma; Nivolumab; PD-1; Pembrolizumab.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / immunology
  • B7-H1 Antigen / antagonists & inhibitors
  • CTLA-4 Antigen / antagonists & inhibitors
  • Humans
  • Immune Tolerance
  • Immunosuppression Therapy
  • Immunotherapy* / adverse effects
  • Immunotherapy* / methods
  • Molecular Targeted Therapy / adverse effects
  • Neoplasms / complications*
  • Neoplasms / immunology
  • Neoplasms / therapy*
  • Neoplasms, Second Primary / etiology
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors
  • Risk
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • B7-H1 Antigen
  • CTLA-4 Antigen
  • Programmed Cell Death 1 Receptor