Checkpoint Inhibitors in Melanoma Patients with Underlying Autoimmune Disease

Figures & data

Table 1 Summary of Case Series Cited in This Review

Study	Patients, n	Tumors (%)	ICI Used (%)	AID (%)	Baseline AID Treatment (%)	AID Flare (%)	irAEs (%)
Cortellini et al^Citation33	85	NSCLC (65.5), melanoma (21.2), RCC (12.5)	Pembrolizumab (24.2), nivolumab (75.8)	AIT (60), psoriasis (13), rheumatologic (11.8), IBD (3.5)	Any (17.6) Steroids (13) Other immunosuppressant (3.5)	47	65.9
Abdel-Wahab et al^Citation34	123	Melanoma (83.7), lung (13), RCC (2.4) merkel cell (0.8)	Ipilimumab (44.7) Nivolumab (27) Pembrolizumab (19) Atezolizumab (0.8) Combination (2.4)	Psoriasis and psoriatic arthritis (22.8) RA (16.3), AIT (8.9), IBD (10.6), MS (4.9), Sarcoidosis (4.1), MG (3.3)	Any (26.7), Steroids (20.8), Synthetic DMARDs (14), Biologic DMARDs (1.0), Other (4.0)	49.5	34
Leonardi et al^Citation35	56	NSCLC (100)	PD-1/PD-L1 (100)	Rheumatologic (45), dermatologic (29), AIT (16), IBD (11), neurologic (5)	Any (20), Steroids (7), Steroid sparing agents (12.5)	23	38
Johnson et al^Citation36	30	Melanoma (100)	Ipilimumab (100)	RA (20), psoriasis (17), IBD (20), MS (7), AIT (10), sarcoidosis (7), SLE (7), other (23)	Any (73), Steroids (33), DMARDs (43)	27	33
Kahler et al^Citation37	41	Melanoma (100)	Ipilimumab (100)	RA (15), psoriasis (17), IBD (7), AIT(37), sarcoidosis (5), MS (2.5)	Any (27), Steroids (14.5), 5-ASA agents (7), Methotrexate (2.4)	29.2	29.2
Menzies et al^Citation38	52	Melanoma (100)	Anti-PD-1	RA (25), IBD (9.6), psoriasis (11.5), sarcoidosis (5.8), other rheumatologic (21), neurologic (10), AIT (8)	Any (38), Steroids (17), Steroid sparing (10), Steroids +SSA (10)	38	29
Grover et al^Citation40	25	Melanoma (40), lung (28), CRC (8), GU (8), gyn (4), merkel cell (4)	Ipilimumab (4) Anti PD-1/PD-L1 (88) Combination (8)	IBD (84), microscopic colitis (16)	Any (40), 5-ASA agents (28), Steroids (8), Anti TNF (8)	28	No data
Abu-Sbeih et al^Citation41	102	Melanoma (44), NSCLC (23), GI (17), GU (7), H+N (4), other (6)	CTLA-4 (7) PD-1/PD-L1 (83) Combination (10)	IBD (100)	Any (58), mesalamine (36), other immunosuppression (22)	41	31
Efuni et al^Citation50	22	Melanoma (32), NSCLC (32), merkel cell (9), H+N (9), GU (10), gyn (5)	Ipilimumab (23) Nivolumab (41) Pembrolizumab (59)	RA (100), other AID present as well (32)	Any (73), Steroids (55), Hydroxychloroquine (14), Methotrexate (32), Other (15)	55	32

Abbreviations: NSCLC, non-small cell lung cancer; RCC, renal cell carcinoma; GU, genitourinary; CRC, colorectal cancer; gyn, gynecologic; AIT, autoimmune thyroid disease; RA, rheumatoid arthritis; MS, multiple sclerosis; IBD, inflammatory bowel disease; DMARD, disease-modifying antirheumatic drug.

Cortellini A, Buti S, Santini D, et al. Clinical outcomes of patients with advanced cancer and pre-existing autoimmune diseases treated with anti-programmed death-1 immunotherapy: a real-world transverse study. Oncologist. 2019;24:e327–e337. doi:10.1634/theoncologist.2018-061830796151

 PubMed Web of Science ®Google Scholar

Abdel-Wahab N, Shah M, Lopez-Olivo MA, Suarez-Almazor ME. Use of checkpoint inhibitors in the treatment of patients with cancer and preexisting autoimmune disease: a systematic review. Ann Int Med. 2018;168(2):121–131. doi:10.7326/M17-207329297009

 PubMed Web of Science ®Google Scholar

Leonardi GC, Gainor JF, Alltan M, et al. Safety of programmed death-1 pathway inhibitors among patients with non-small-cell lung cancer and preexisting autoimmune disorders. J Clin Oncol. 2018;36:1905–1912.29746230

 PubMed Web of Science ®Google Scholar

Johnson DB, Sullivan RJ, Ott PA, et al. Ipilimumab therapy in patients with advanced melanoma and preexisting autoimmune disorders. JAMA Oncol. 2016;2(2):234–240. doi:10.1001/jamaoncol.2015.436826633184

 PubMed Web of Science ®Google Scholar

Kahler KC, Eigentler TK, Gesierich A, et al. Ipilimumab in metastatic melanoma patients with pre-existing autoimmune disorders. Cancer Immunol Immunother. 2018;67(5):825–834. doi:10.1007/s00262-018-2134-z29487980

 PubMed Web of Science ®Google Scholar

Menzies AM, Johnson DB, Ramanujam S, et al. Anti-PD-1 therapy in patients with advanced melanoma and preexisting autoimmune disorders or major toxicity with ipilimumab. Ann Oncol. 2017;28(2):368–376. doi:10.1093/annonc/mdw44327687304

 PubMed Web of Science ®Google Scholar

Grover S, Ruan AB, Srivoleti P, et al. Safety of immune checkpoint inhibitors in patients with pre-existing inflammatory bowel disease and microscopic colitis. JOP. 2020;16(9):e933–e941.

 Google Scholar

Abu-Sbeih H, Faleck DM, Riccitui B, et al. Immune checkpoint inhibitor therapy in patients with preexisting inflammatory bowel disease. J Clin Oncol. 2020;38(6):576–583. doi:10.1200/JCO.19.0167431800340

 PubMed Web of Science ®Google Scholar

Efuni E, Cytryn S, Boland P, et al. Risk of toxicity after initiating immune checkpoint inhibitor treatment in patients with rheumatoid arthritis. J Clin Rheum. 2020.

 Web of Science ®Google Scholar