Abstract
This letter describes the potential effect of B cell depletion on immune related adverse events associated with immune checkpoint inhibition. B cell depleting agents such as rituximab reduce B cell to plasma cell differentiation and antibody production. This treatment strategy is used in several immune mediated inflammatory diseases such as rheumatoid arthritis and small vessel vasculitis. The immune related adverse events associated with immune checkpoint inhibition resemble immune mediated inflammatory diseases. Here, we report a lower incidence of hypothyroidism in a trial of combined B cell depletion and immune checkpoint inhibitor treatment compared with studies of immune checkpoint inhibitor monotherapy. This letter aims to increase awareness of the immune related adverse events associated with immune checkpoint inhibition in future clinical trials of immune checkpoint inhibition together with B cell depletion (primarily trials of B cell lymphomas). Hopefully, observations from these clinical trials can guide future treatment strategies to treat or prevent immune related adverse events associated with immune checkpoint inhibition.
Highlights
This letter describes the potential effect of B cell depletion on immune related adverse events associated with immune checkpoint inhibition
The decade will bring fundamental knowledge about the immunology behind the immune related adverse events associated with immune checkpoint inhibition (ICI). This knowledge will come as a consequence of new clinical trials of ICI together with B cell depletion
ICI refers to blocking antibodies targeting the programmed cell death protein 1 (PD1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA4) pathways
Summary
This letter describes the potential effect of B cell depletion on immune related adverse events associated with immune checkpoint inhibition. This knowledge will come as a consequence of new clinical trials of ICI together with B cell depletion. During ICI 35% of cancer patients develop irAEs. This type of adverse events resembles immune mediated inflammatory diseases (IMIDs).
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