1. Opportunistic autoimmunity secondary to cancer immunotherapy (OASI): An emerging challenge
- Author
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Philippe Halfon, Patrick Blanco, Marie Kostine, Estibaliz Lazaro, Frédérique Retornaz, Caroline Charpin, Noémie Jourde-Chiche, Christophe Richez, Denis Arniaud, Laurent Chiche, C. Stavris, Département de Rhumatologie, CHU Bordeaux [Bordeaux]-Université de Bordeaux (UB), Hôpital Européen de Marseille (HEM), Hôpital du Haut-L'Evêque, Hôpital Européen [Fondation Ambroise Paré - Marseille], Hôpital Saint-Joseph [Marseille], Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Université de Bordeaux (UB)-CHU Bordeaux [Bordeaux], and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Oncology ,medicine.medical_specialty ,Drug-Related Side Effects and Adverse Reactions ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Antineoplastic Agents ,Autoimmunity ,medicine.disease_cause ,Autoimmune Diseases ,03 medical and health sciences ,0302 clinical medicine ,Cancer immunotherapy ,Neoplasms ,Internal medicine ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Enzyme Inhibitors ,Adverse effect ,Cancer ,business.industry ,Melanoma ,Gastroenterology ,Antibodies, Monoclonal ,Cell Cycle Checkpoints ,Immunotherapy ,medicine.disease ,3. Good health ,030220 oncology & carcinogenesis ,Immunology ,Adenocarcinoma ,Opportunistic ,business ,Adjuvant ,Checkpoint inhibitors - Abstract
International audience; With "checkpoint inhibitors" targeting PD1/PD-1-ligands or CTLA-4/CD28 pathways, immunotherapy has profoundly modified therapeutic strategies in oncology. First approved in refractory metastatic neoplasms (melanoma and lung adenocarcinoma), it is now being tested broadly in other cancers and/or as adjuvant treatment. For a significant proportion of patients, immunotherapy is responsible for "immunological" events, identified as Immune-Related Adverse Events (irAEs). Owing to the increasing number of prescriptions, identification and management of specific immunological side effects is crucial and requires close collaboration between oncologists and internists and/or other organ specialists. Within irAEs, we propose to individualize the induced autoimmunity by the term "Opportunistic Autoimmunity Secondary to Cancer Immunotherapy" (OASI). The aims of this article are (1) to present the different available checkpoint inhibitors and the OASIs reported with these treatments and (2) to propose practical recommendations for diagnosis, pre-therapeutic assessment and management of OASIs. The need for predictive biomarkers of OASIs occurrence will also be discussed.
- Published
- 2017