Abstract
BackgroundThe comprehensive measurement of autoimmune disease-related antibodies (Abs) before immune checkpoint inhibitor (ICI) treatment may be useful for predicting the development of immune-related adverse events (irAEs); however, the clinical utility is not well known.Materials and methodsWe retrospectively analyzed patients with advanced solid tumors treated with ICI monotherapy or doublet combination therapy between July 2014 and December 2020 at single institute. Anti-nuclear antibody (ANA), anti-thyroglobulin (Tg) Ab, anti-thyroid peroxidase (TPO) Ab, anti-glutamic acid decarboxylase (GAD) Ab, anti-acetylcholine esterase receptor (AchR) Ab, and platelet-associated immunoglobulin G (PA-IgG) Ab were comprehensively measured for the screening before ICI therapy.ResultsOf 275 registered patients (median age, 70 years; male, 64.4%; Eastern Cooperative Oncology Group performance status of 0 or 1, 88.7%; and prior regimen of 0-1/≥2, 88.7%/11.3%), 128 non-small-cell lung cancer, 35 gastric cancer, 33 head and neck cancer, 24 melanoma, 19 renal cell carcinoma, 13 urothelial carcinoma, 12 esophageal cancer, 5 malignant mesothelioma of pleura, 2 endometrial cancer, and 4 other cancer were included. The number of patients with positive ANA, Tg, TPO, PA-IgG, GAD, and AchR Abs was 52 (24.9%), 38 (14.5%), 11 (10.1%), 6 (3.5%), 5 (2.0%), and 1 (0.5%), respectively. There was no association between the development of any irAEs and Abs positivity, while thyroid dysfunction developed more frequently among patients with than without Tg Ab or TPO Ab (39.5% versus 12.5%, P < 0.01; 45.5% versus 14.3%, P = 0.02).ConclusionsThe clinical utility of comprehensive measurement of autoimmune disease-related Abs before introduction of ICI therapy was limited for predicting irAE. However, Tg and TPO Abs were risk factors as regards the development of ICI-induced thyroid dysfunction.
Highlights
Immune checkpoint inhibitors (ICIs) have rapidly changed the therapeutic landscape, and have been considered as key drugs for patients with cancer
Toi et al showed that the presence of the examined preexisting antibodies (Abs), such as rheumatoid factor (RF), anti-nuclear antibody (ANA), anti-thyroglobulin (Tg) Ab, and anti-thyroid peroxidase (TPO) Ab before ICI therapy was associated with the development of immune-related adverse events (irAEs) in patients with non-small-cell lung cancer (NSCLC).[2]
We retrospectively reviewed the medical records of the patients and evaluated clinical information, such as age, sex, Eastern Cooperative Oncology Group (ECOG) performance status (PS), cancer type, history of autoimmune disease, type of ICIs, treatment line, irAEs during ICI therapy, discontinuation of ICI according to irAEs and Abs before and during treatment, Antinuclear antibody (ANA), Tg Ab, TPO Ab, glutamic acid decarboxylase (GAD) Ab, acetylcholine esterase receptor (AchR) Ab, and platelet-associated immunoglobulin G (PA-IgG)
Summary
Immune checkpoint inhibitors (ICIs) have rapidly changed the therapeutic landscape, and have been considered as key drugs for patients with cancer. Toi et al showed that the presence of the examined preexisting antibodies (Abs), such as rheumatoid factor (RF), anti-nuclear antibody (ANA), anti-thyroglobulin (Tg) Ab, and anti-thyroid peroxidase (TPO) Ab before ICI therapy was associated with the development of irAEs in patients with non-small-cell lung cancer (NSCLC).[2]. The comprehensive measurement of autoimmune disease-related antibodies (Abs) before immune checkpoint inhibitor (ICI) treatment may be useful for predicting the development of immune-related adverse events (irAEs); the clinical utility is not well known. Antinuclear antibody (ANA), anti-thyroglobulin (Tg) Ab, anti-thyroid peroxidase (TPO) Ab, anti-glutamic acid decarboxylase (GAD) Ab, anti-acetylcholine esterase receptor (AchR) Ab, and platelet-associated immunoglobulin G (PA-IgG) Ab were comprehensively measured for the screening before ICI therapy. Conclusions: The clinical utility of comprehensive measurement of autoimmune disease-related Abs before introduction of ICI therapy was limited for predicting irAE.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
