Immune checkpoint inhibitors may be safe for patients with preexisting autoimmune disease

Abstract

Immune checkpoint inhibitors (ICIs) are becoming first-line therapeutic options in oncology for more and more malignancies, including metastatic melanoma, non–small cell lung cancer, and kidney cancer, as well as adjuvant therapy for certain forms of melanoma. However, because of immune-related adverse events (irAEs), patients with preexisting autoimmune diseases (PADs) have been excluded from clinical trials of ICIs, even though many clinicians suspect these patients might benefit from these drugs. The main concern is that unleashing severe inflammatory and autoimmune toxicity might exacerbate a patient’s PAD or compromise their ability to tolerate ICI therapy.