McGonagle, D, Bragazzi, NL, Amital, H et al. (1 more author) (2020) Mechanistic classification of immune checkpoint inhibitor toxicity as a pointer to minimal treatment strategies to further improve survival. Autoimmunity Reviews, 19 (2). 102456. ISSN 1568-9972
Abstract
Improved anti-tumour responses under immune checkpoint inhibition (ICI) are associated with concomitant autoimmune disease development termed immune related adverse events (irAEs), of which approximately 5% are rheumatic in nature. Generally, oncologists and other specialists vigorously treat irAEs in spite of the generally accepted beneficial effect of irAEs on tumour survival. Herein, we highlight mechanistic insights on how tumour responses and certain types of autoimmunity appear to be inextricably linked around CD8+ T-cell mediated responses and that strategies that interfere with such shared immunopathgenesis could impact of survival. We discuss the possible circumstances in which intensive immunosuppressive therapy for irAEs that occur with ICIs might blunt anti-tumour immunity. We also discuss potential therapeutic strategies for emergent ICI related autoimmunity and propose some treatment considerations and research questions to minimize the impact of overzealous immunosuppression strategies on tumour responses. Thus, refraining from using powerful therapeutic armamentarium to treat irAEs, especially when these are not considered as life-threating might improve the prognosis of ICI therapy.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019, Elsevier B.V. All rights reserved. This is an author produced version of an article published in Autoimmunity Reviews. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Immune checkpoint inhibitors; ICI; Immune related adverse events; irAEs |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Experimental Musculoskeletal Medicine (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 27 Jan 2020 11:17 |
Last Modified: | 12 Dec 2020 01:38 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.autrev.2019.102456 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:156050 |
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