Immune checkpoint inhibitor rechallenge in patients who previously experienced immune-related inflammatory arthritis: a multicentre observational study
Objective Another course of immune checkpoint inhibitors (ICIs) is often considered in patients with cancer progression and previous immune-related adverse events, including inflammatory arthritis (ICI-IA), but there are limited data regarding safety of ICI rechallenge in this setting. We aimed to a...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-10-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/9/4/e003795.full |
| _version_ | 1797366759690338304 |
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| author | Samuel Bitoun Marie Kostine Christophe Richez Thomas Barnetche Thierry Schaeverbeke Gael Mouterde Marie-Elise Truchetet Maéva Zysman Amaury Daste Sorilla Prey Alice Tison Rémi Veillon Caroline Dutriaux Anne Pham-Ledard Marie Beylot-Barry Marine Gross-Goupil Félix Lefort Alexandra Ladouceur Emilie Gerard Charlotte Domblides Baptiste Sionneau Mathieu Larroquette |
| author_facet | Samuel Bitoun Marie Kostine Christophe Richez Thomas Barnetche Thierry Schaeverbeke Gael Mouterde Marie-Elise Truchetet Maéva Zysman Amaury Daste Sorilla Prey Alice Tison Rémi Veillon Caroline Dutriaux Anne Pham-Ledard Marie Beylot-Barry Marine Gross-Goupil Félix Lefort Alexandra Ladouceur Emilie Gerard Charlotte Domblides Baptiste Sionneau Mathieu Larroquette |
| author_sort | Samuel Bitoun |
| collection | DOAJ |
| description | Objective Another course of immune checkpoint inhibitors (ICIs) is often considered in patients with cancer progression and previous immune-related adverse events, including inflammatory arthritis (ICI-IA), but there are limited data regarding safety of ICI rechallenge in this setting. We aimed to assess the rate and clinical features associated with ICI-IA flare/recurrence on ICI rechallenge.Methods We conducted a multicentre observational study including cancer patients with ICI-IA who started a second course of ICI more than 3 months after ICI discontinuation in four French university hospitals. Primary outcome was the frequency of ICI flare/recurrence after ICI rechallenge.Results Twenty-three patients were included. At the time of ICI rechallenge, 18 patients reported no symptoms of ICI-IA (78%) and 5 had grade 1 (22%), 11 patients (48%) were not receiving any ICI-IA treatment, 11 (48%) were still on prednisone, 2 (9%) were on conventional synthetic disease-modifying antirheumatic drugs and 1 (4%) on anti-IL-6. ICI-IA flare/recurrence occurred in 12 patients (52%) with a median time of 1 month after ICI rechallenge. ICI-IA phenotype, disease activity and ICI-IA treatment at the time of ICI rechallenge did not differ according to ICI-IA flare/recurrence status.Conclusion In this first observational study of ICI-IA patients rechallenged with ICI, about half of the patients experienced ICI-IA flare/recurrence with a similar phenotype but occurring earlier than the initial ICI-IA, warranting close monitoring during the first month of retreatment. Risk of flare did not differ according to baseline immunosuppressive treatment at the time of rechallenge. |
| first_indexed | 2024-03-08T17:09:16Z |
| format | Article |
| id | doaj.art-dd729db8de80406ebd7112cf82a7704c |
| institution | Directory Open Access Journal |
| issn | 2056-5933 |
| language | English |
| last_indexed | 2024-03-08T17:09:16Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj.art-dd729db8de80406ebd7112cf82a7704c2024-01-04T02:15:10ZengBMJ Publishing GroupRMD Open2056-59332023-10-019410.1136/rmdopen-2023-003795Immune checkpoint inhibitor rechallenge in patients who previously experienced immune-related inflammatory arthritis: a multicentre observational studySamuel Bitoun0Marie Kostine1Christophe Richez2Thomas Barnetche3Thierry Schaeverbeke4Gael Mouterde5Marie-Elise Truchetet6Maéva Zysman7Amaury Daste8Sorilla Prey9Alice Tison10Rémi Veillon11Caroline Dutriaux12Anne Pham-Ledard13Marie Beylot-Barry14Marine Gross-Goupil15Félix Lefort16Alexandra Ladouceur17Emilie Gerard18Charlotte Domblides19Baptiste Sionneau20Mathieu Larroquette21Rheumatology, Université Paris Saclay, Hôpital Bicetre, Assistance Publique-Hôpitaux de Paris, FHU CARE, Le Kremlin-Bicetre, FranceRheumatology, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, FranceRheumatology, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, FranceRheumatology, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, FranceRheumatology, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, FranceRheumatology, Hôpital Lapeyronie, Montpellier, FranceRheumatology, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, FrancePulmonology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceOncology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceDermatology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceRheumatology, CHRU de Brest, Brest, FrancePulmonology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceDermatology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceDermatology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceDermatology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceDepartment of Medical Oncology, University Hospital of Bordeaux, Bordeaux, FranceDepartment of Medical Oncology, University Hospital of Bordeaux, Bordeaux, FranceRheumatology, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, FranceDermatology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceOncology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceOncology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceOncology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceObjective Another course of immune checkpoint inhibitors (ICIs) is often considered in patients with cancer progression and previous immune-related adverse events, including inflammatory arthritis (ICI-IA), but there are limited data regarding safety of ICI rechallenge in this setting. We aimed to assess the rate and clinical features associated with ICI-IA flare/recurrence on ICI rechallenge.Methods We conducted a multicentre observational study including cancer patients with ICI-IA who started a second course of ICI more than 3 months after ICI discontinuation in four French university hospitals. Primary outcome was the frequency of ICI flare/recurrence after ICI rechallenge.Results Twenty-three patients were included. At the time of ICI rechallenge, 18 patients reported no symptoms of ICI-IA (78%) and 5 had grade 1 (22%), 11 patients (48%) were not receiving any ICI-IA treatment, 11 (48%) were still on prednisone, 2 (9%) were on conventional synthetic disease-modifying antirheumatic drugs and 1 (4%) on anti-IL-6. ICI-IA flare/recurrence occurred in 12 patients (52%) with a median time of 1 month after ICI rechallenge. ICI-IA phenotype, disease activity and ICI-IA treatment at the time of ICI rechallenge did not differ according to ICI-IA flare/recurrence status.Conclusion In this first observational study of ICI-IA patients rechallenged with ICI, about half of the patients experienced ICI-IA flare/recurrence with a similar phenotype but occurring earlier than the initial ICI-IA, warranting close monitoring during the first month of retreatment. Risk of flare did not differ according to baseline immunosuppressive treatment at the time of rechallenge.https://rmdopen.bmj.com/content/9/4/e003795.full |
| spellingShingle | Samuel Bitoun Marie Kostine Christophe Richez Thomas Barnetche Thierry Schaeverbeke Gael Mouterde Marie-Elise Truchetet Maéva Zysman Amaury Daste Sorilla Prey Alice Tison Rémi Veillon Caroline Dutriaux Anne Pham-Ledard Marie Beylot-Barry Marine Gross-Goupil Félix Lefort Alexandra Ladouceur Emilie Gerard Charlotte Domblides Baptiste Sionneau Mathieu Larroquette Immune checkpoint inhibitor rechallenge in patients who previously experienced immune-related inflammatory arthritis: a multicentre observational study RMD Open |
| title | Immune checkpoint inhibitor rechallenge in patients who previously experienced immune-related inflammatory arthritis: a multicentre observational study |
| title_full | Immune checkpoint inhibitor rechallenge in patients who previously experienced immune-related inflammatory arthritis: a multicentre observational study |
| title_fullStr | Immune checkpoint inhibitor rechallenge in patients who previously experienced immune-related inflammatory arthritis: a multicentre observational study |
| title_full_unstemmed | Immune checkpoint inhibitor rechallenge in patients who previously experienced immune-related inflammatory arthritis: a multicentre observational study |
| title_short | Immune checkpoint inhibitor rechallenge in patients who previously experienced immune-related inflammatory arthritis: a multicentre observational study |
| title_sort | immune checkpoint inhibitor rechallenge in patients who previously experienced immune related inflammatory arthritis a multicentre observational study |
| url | https://rmdopen.bmj.com/content/9/4/e003795.full |
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