Table 1.
Summary of key studies using ICI in patients with cancer and pre-existing autoimmune diseases.
| Main pre-existing AD | ICI used | Number of patients | Flare of pre-existing AD after ICIs | New irAEs | Management | Reference |
|---|---|---|---|---|---|---|
| Psoriasis, MS, RA, SLE, IBD, sarcoidosis, thyroiditis | Anti-CTLA-4 | 30 | 27% | 33% | Steroid, SSA (infliximab) | (141) |
| PMR, SLE, RA, psoriasis, IBD, SS | Anti-PD-1 | 52 | 38% | 29% | Steroid, SSA, IVIG, ICI discontinuation 11% | (142) |
| RA, vitiligo, thyroiditis, SS | Anti-PD-1 | 45 | 24% | 44% | Steroid, ICI discontinuation 25% | (143) |
| Psoriasis, RA, PMR, IBD, thyroiditis | Anti-PD-1 or anti-PD-L1 | 56 | 23% | 38% | Steroid, ICI discontinuation 14% | (144) |
| RA, psoriasis, IBD, thyroiditis | Anti-CTLA-4 | 41 | 29% | 29% | Steroid, SSA (infliximab, hydroxychloroquine, sulfasalazine) | (145) |
| RA, thyroiditis, psoriasis, IBD, PMR, SLE | Anti-PD-1 | 85 | 47% | 66% | ICI discontinuation 7% | (146) |
| RA, psoriasis, IBD, SLE, PMR | All ICIs (anti-CTLA-4, anti-PD-1, anti-PD-L1) | 112 | 47% | 42% | Steroid, SSA (azathioprine, methotrexate, TNF inhibitor), IVIG, ICI discontinuation 21% | (147) |
| RA | All | 22 | 55% | 32% | Steroid, ICI discontinuation 23% | (148) |
| RA, PMR, SLE, psoriasis, sarcoidosis, IBD, thyroiditis | All | 106 | 36% | 38% | Steroid, SSA (methotrexate, rituximab, infliximab), ICI discontinuation 20% | (149) |
| RA, thyroiditis, psoriasis | Anti-PD-L1 | 35 | 11% | 46% | Steroid, ICI discontinuation 9% | (150) |
| RA, type 1 DM, atrophic gastritis | All | 106 | N/A | 58% | N/A | (151) |
| RA, SLE, SSc, IBD, sarcoidosis, hyperthyroid-ism, hypothyroid-ism | All | 415 | N/A | Comb. 44%, anti-CTLA-4 30%, anti-PD-1 17% | Steroid, SSA (TNF inhibitor), ICI discontinuation 17% | (152) |
| SLE, RA, psoriasis, IBD, sarcoidosis | Anti-PD-1 | 47 | 26% | N/A | Steroid, ICI discontinuation 11% | (153) |
| RA, hypothyroidism, psoriasis | Anti-PD-1, anti-PD-L1 or combination | 63 | 31% | 62% | Steroid, SSA | (154) |
| RA, PMR, SLE, IBD, psoriasis, scleroderma, sarcoidosis | Anti-CTLA-4, anti-PD-1 or combination | 74 | N/A | 50% mild, 37% severe | N/A | (140) |
| IBD, RA, MS, hypothyroidism, microscopic colitis | Anti-CTLA-4, anti-PD-1, anti-PD-L1 or combination | 197 | 14.7% | 25.3% | Steroid, infiximab and vedolizumab | (155) |
IBD, inflammatory bowel disease; ICI, immune-checkpoint inhibitor; IVIG, intravenous immunoglobulins; MS, multiple sclerosis; N/A, not applicable; PMR, polymyalgia rheumatica; SS: Sjögren’s syndrome; RA, rheumatoid arthritis; SLE, systemic lupus erythematosus; SSA, steroid-sparing agent.