Tyck till om SwePub Sök
här!
Sökning: onr:"swepub:oai:lup.lub.lu.se:d4a97819-f5b1-4eb9-b409-e8be02cd87e2" >
Sicca/Sjögren's syn...
Sicca/Sjögren's syndrome triggered by PD-1/PD-L1 checkpoint inhibitors. Data from the International Immunocancer Registry (ICIR)
-
- Ramos-Casals, Manel (författare)
- Hospital Clínic of Barcelona,Institutd' Investigacions Biomèdiques August Pi iSunyer (IDIBAPS)
-
- Olsson, Peter (författare)
- Lund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Skåne University Hospital
-
- Calabrese, C (författare)
- Case Western Reserve University
-
(creator_code:org_t)
-
- 2019
- 2019
- Engelska.
-
Ingår i: Clinical and Experimental Rheumatology. - 1593-098X. ; 37, s. 114-122
- Relaterad länk:
-
https://www.clinexpr... (free)
-
visa fler...
-
https://lup.lub.lu.s...
-
visa färre...
Abstract
Ämnesord
Stäng
- Objective. To analyse the worldwide occurrence of sicca/Sjögren's (SS) syndrome associated with the use of immune checkpoint inhibitors (ICI) in patients with cancer. Methods. The ImmunoCancer International Registry (ICIR) is a Big Data- Sharing multidisciplinary network composed by 40 specialists in Rheumatology, Internal Medicine, Immunology and Oncology from 18 countries focused on the clinical and basic research of the immune-related adverse events (irAEs) related to cancer immunotherapies. For this study, patients who were investigated for a clinical suspicion of SS after being exposed to ICI were included. Results. We identified 26 patients (11 women and 15 men, with a mean age at diagnosis of 63.57 years). Underlying cancer included lung (n=12), renal (n=7), melanoma (n=4), and other (n=3) neoplasia. Cancer immunotherapies consisted of monotherapy (77%) and combined regimens (23%). In those patients receiving monotherapy, all patients were treated with PD-1/PD-L1 inhibitors (nivolumab in 9, pembrolizumab in 7 and durvalumab in 4); no cases associated with CTLA-4 inhibitors were identified. The main SS-related features consisted of dry mouth in 25 (96%) patients, dry eye in 17 (65%), abnormal ocular tests in 10/16 (62%) and abnormal oral diagnostic tests in 12/14 (86%) patients. Minor salivary gland biopsy was carried out in 15 patients: histopathological findings consisted of mild chronic sialadenitis in 8 (53%) patients and focal lymphocytic sialadenitis in the remaining 7 (47%); a focus score was measured in 5 of the 6 patients (mean of 1.8, range 1-4). Immunological markers included positive ANA in 13/25 (52%), anti-Ro/ SS-A in 5/25 (20%), RF in 2/22 (9%), anti-La/SS-B in 2/25 (8%), low C3/C4 levels in 1/17 (6%) and positive cryoglobulins in 1/10 (10%). Classification criteria for SS were fulfilled by 10 (62%) out of 16 patients in whom the two key classificatory features were carried out. Among the 26 patients, there were only 3 (11%) who presented exclusively with sicca syndrome without organ-specific autoimmune manifestations. Therapeutic management included measures directed to treat sicca symptoms and therapies against autoimmune-mediated manifestations (glucocorticoids in 42%, second/ third-line therapies in 31%); therapeutic response for systemic features was observed in 8/11 (73%). No patient died due to autoimmune involvement. Conclusion. Patients with Sjögren's syndrome triggered by ICI display a very specific profile different from that reported in idiopathic primary SS, including more frequent occurrence in men, a higher mean age, a predominant immunonegative serological profile, and a notable development of organ-specific autoimmune involvement in spite of the poor immunological profile. The close association found between sicca/Sjögren's syndrome and primarily PD-1 blockade requires further specific investigation. © COPYRIGHT CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 2019.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- Durvalumab
- Immune checkpoint inhibitors
- Nivolumab
- Pembrolizumab
- Sjögren's syndrome
- antinuclear antibody
- cevimeline
- cryoglobulin
- cyclosporine
- durvalumab
- glucocorticoid
- interleukin 10
- ipilimumab
- La antibody
- methylprednisolone
- nivolumab
- pembrolizumab
- pilocarpine
- programmed death 1 ligand 1
- programmed death 1 receptor
- rheumatoid factor
- Ro antibody
- adult
- aged
- Article
- autoimmune disease
- cancer combination chemotherapy
- cancer immunotherapy
- cancer registry
- chordoma
- clinical article
- colon cancer
- dry eye
- eye examination
- female
- histopathology
- human
- human tissue
- kidney cancer
- lung cancer
- male
- melanoma
- middle aged
- monotherapy
- mouth examination
- priority journal
- retrospective study
- salivary gland biopsy
- sialoadenitis
- Sjoegren syndrome
- uterine cervix cancer
- xerostomia
- immunology
- minor saliva gland
- register
- B7-H1 Antigen
- Female
- Humans
- Male
- Middle Aged
- Programmed Cell Death 1 Receptor
- Registries
- Salivary Glands, Minor
- Sjogren's Syndrome
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
Hitta via bibliotek
Till lärosätets databas