Evidence map›Paper›PMID 33471137›Full record

Trial reportCancer immunology, immunotherapy : CII2021

Preexisting autoimmune disease and immune-related adverse events associated with anti-PD-1 cancer immunotherapy: a national case series from the Canadian Research Group of Rheumatology in Immuno-Oncology.

Sabrina Hoa, Linda Laaouad, Janet Roberts, Daniel Ennis, Carrie Ye, Karam Al Jumaily, Janet Pope, Tatiana Nevskaya, Alexandra Saltman, Megan Himmel and 8 more

Open access · greenAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Cancer immunology, immunotherapy : CII, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 4 pooled it
5.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 77 citations in OpenAlex.

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  18. Systemic Sclerosis Association with Malignancy.Clinical reviews in allergy & immunology · 2022
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  20. Neurotoxicity and safety of the rechallenge of immune checkpoint inhibitors: a growing issue in neuro-oncology practice.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 10 institutions in 1 country.

Sabrina HoaDivision of Rheumatology, Centre hospitalier de l'Université de Montréal, E-514, 264 boul. René-Lévesque East, Montreal, QC, H2X 1P1, Canada. sabrina.hoa@mail.mcgill.ca.ORCID http://orcid.org/0000-0002-9466-5729
Linda LaaouadDivision of Rheumatology, Centre hospitalier de l'Université de Montréal, E-514, 264 boul. René-Lévesque East, Montreal, QC, H2X 1P1, Canada.
Janet RobertsDivision of Rheumatology, Dalhousie University, Halifax, NS, Canada.
Daniel EnnisDivision of Rheumatology, University of British Columbia, Vancouver, BC, Canada.
Carrie YeDivision of Rheumatology, University of Alberta, Edmonton, AB, Canada.
Karam Al JumailyDivision of Rheumatology, University of Alberta, Edmonton, AB, Canada.
Janet PopeDivision of Rheumatology, University of Western Ontario, London, ON, Canada.
Tatiana NevskayaDivision of Rheumatology, University of Western Ontario, London, ON, Canada.
Alexandra SaltmanDivision of Rheumatology, University of Toronto, Toronto, ON, Canada.
Megan HimmelDivision of Rheumatology, University of Toronto, Toronto, ON, Canada.
Robert RottapelDivision of Rheumatology, University of Toronto, Toronto, ON, Canada.
Christina LyDivision of Rheumatology, McGill University, Montreal, QC, Canada.
Ines ColmegnaDivision of Rheumatology, McGill University, Montreal, QC, Canada.
Aurore Fifi-MahDivision of Rheumatology, University of Calgary, Calgary, AB, Canada.
Nancy MaltezDivision of Rheumatology, University of Ottawa, Ottawa, ON, Canada.
Annaliese TisseverasingheDivision of Rheumatology, University of Manitoba, Winnipeg, MB, Canada.
Marie HudsonDivision of Rheumatology, McGill University, Montreal, QC, Canada.
Shahin JamalDivision of Rheumatology, University of British Columbia, Vancouver, BC, Canada.
McGill University · CAUniversity of Toronto · CACentre Hospitalier de l’Université de Montréal · CAUniversity of Alberta · CAUniversity of British Columbia · CAWestern University · CADalhousie University · CAUniversity of Calgary · CAUniversity of Manitoba · CAUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLimited data are available on the safety and efficacy of immune checkpoint inhibitors (ICI) in patients with preexisting autoimmune diseases (PAD).

methodsRetrospective study of patients with PAD referred for rheumatologic evaluation prior to starting or during immunotherapy between January 2013 and July 2019 from 10 academic sites across Canada. Data were extracted by chart review using a standardized form.

resultsTwenty-seven patients with PAD on ICI therapy were identified. The most common PADs were rheumatoid arthritis (30%), psoriasis/psoriatic arthritis (30%), inflammatory bowel disease (IBD, 15%) and axial spondyloarthritis (11%), and the most frequently observed cancers were lung cancer and melanoma. All patients received anti-PD-1 therapies, and 2 received additional sequential anti-CTLA-4 therapy. PAD exacerbations occurred in 52% over a median (IQR) follow-up of 11.0 (6.0-17.5) months, with 14% being severe, 57% requiring corticosteroids, 50% requiring immunosuppression and 14% requiring ICI discontinuation. Flares were generally more frequent and severe in patients who previously required more intensive immunosuppression (i.e., biologics). Flares occurred despite background immunosuppression at the time of ICI initiation. In patients with preexisting psoriasis, IBD and axial spondyloarthritis, rheumatic immune-related adverse events (irAEs), mostly polyarthritis and tenosynovitis, were frequently observed. Tumor progression was not associated with exposure to immunosuppressive drugs before or after ICI initiation and was numerically less frequent in patients with irAEs.

conclusionPAD exacerbations in the context of ICI treatment are common, although generally mild, and occur despite background immunosuppression. Exacerbations are more frequent and severe in patients on more intensive immunosuppressive therapies pre-immunotherapy.

Indexed as

Antibodies, MonoclonalAutoimmune DiseasesCanadaFemaleHumansImmunosuppressive AgentsImmunotherapyLung NeoplasmsMaleMedical OncologyMelanomaMiddle AgedProgrammed Cell Death 1 ReceptorProspective StudiesRetrospective StudiesRheumatologyAntibodies, MonoclonalImmunosuppressive AgentsPDCD1 protein, humanProgrammed Cell Death 1 ReceptorAdverse eventsAutoimmuneCancerCheckpoint inhibitorImmunotherapyPreexisting

Identifiers

PMID33471137
PMCPMC10992076
OpenAlexW3122051635

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.