Autoanticuerpos: una manifestación de los eventos adversos inmunológicos de la inmunoterapia en cáncer

Abstract

IntroductionImmunotherapy with checkpoint inhibitors has shown to be one of the most effective new strategies to treat some types of cancer. However, stopping the suppression induced by the checkpoints, mainly CTLA-4 and PD-1 / PD-L1, makes patients prone to develop different immune reactions that can range from mild organ involvement to life-threatening compromises. This highlights the importance that patients should be carefully evaluated during treatment in order to detect and understand these types of manifestations, and find tools for their management. ObjectivesTo determine the autoantibody profile of patients under treatment with checkpoint inhibitors (ICI), with or without symptoms suggestive of rheumatological disease associated with the therapy. The clinical and demographical characteristics of such patients were also analysed. MethodsPatients diagnosed with cancer and under treatment with ICI were recruited. Sera were evaluated with commercial kits to determine the presence of autoantibodies. The presence of immune-related adverse events (irAEs) was evaluated according to the definitions proposed in the guidelines of the American Society of Clinical Oncology. ResultsOf the twenty-four patients evaluated, fifteen presented with at least one adverse immunological event, where dermatological and musculoskeletal were the most prevalent. Autoantibodies were obtained from the serum of 22 patients. Nineteen of them had at least one autoantibody, with antinuclear and anti-smooth muscle antibodies being the most prevalent. ConclusionThe seroprevalence found in our study suggests that autoantibodies may be part of irAEs in patients treated with ICI. However, more studies are required to define the usefulness of autoantibody detection in these patients in order to predict clinical manifestations.