Checkpoint Inhibitors in Melanoma Patients with Underlying Autoimmune Disease

Abstract

The development of immune checkpoint inhibitors (ICI) has dramatically changed the clinical management of metastatic melanoma and other solid tumors. Despite exclusion from initial clinical trials, there is a growing body of retrospective data that suggest ICI can be used in patients with underlying autoimmune disease (AID) with a tolerable level of anticipated immune-related adverse events (irAEs) and a rate of severe irAEs comparable to that of patients without underlying AID. Coordination with other subspecialists and careful monitoring for irAEs is critical in safely managing these patients. Studies exploring novel approaches examining the use of targeted immunosuppressants in the prevention and management of irAEs, as well as multiple studies currently underway are aimed at establishing safe clinical practices when using ICI in patients with underlying AID.

Keywords:

• immune checkpoint inhibitor
• melanoma
• autoimmune disease

Disclosure

Dr April K Salama reports grants from Bristol Myers Squibb, grants from Immunocore, grants from Merck, grants from Nektar Therapeutics, personal fees from Novartis, personal fees from Pfizer, personal fees from Iovance, personal fees from Regeneron, outside the submitted work. The authors report no other conflicts of interest in this work.