Immune checkpoint inhibitors and rheumatic adverse events

Abstract

Immune checkpoint inhibitors are used with increasing regularity in metastatic disease. Anti-CTLA4 (ipilimumab) anti-PD1 (pembrolizumab, nivolumab) or anti-PD-L1(avelumab, atezolizumab) are approved for use in metastatic melanoma, non-small cell lung cancer, renal cell carcinoma and other malignancies. Despite their advantages, their immune adverse reactions are important. This paper is a review current literature regarding rheumatologic adverse reactions that follow ICI treatment. Their frequency is not high but it is important to correctly diagnose and treat them. Most of the adverse reactions are mild and moderate. The treatment for immune related adverse events (IRAEs) is currently not supported by a sufficient amount of studies. The best treatment option is therefore based on the rheumatologist experience.