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dc.contributor.authorMitchell, Emma L-
dc.contributor.authorLau, Peter Kar Han-
dc.contributor.authorKhoo, Chloe-
dc.contributor.authorLiew, David F-
dc.contributor.authorLeung, Jessica-
dc.contributor.authorLiu, Bonnia-
dc.contributor.authorRischin, Adam-
dc.contributor.authorFrauman, Albert G-
dc.contributor.authorKee, Damien-
dc.contributor.authorSmith, Kortnye-
dc.contributor.authorBrady, Benjamin-
dc.contributor.authorRischin, Danny-
dc.contributor.authorGibson, Andrew-
dc.contributor.authorMileshkin, Linda-
dc.contributor.authorKlein, Oliver-
dc.contributor.authorWeickhardt, Andrew-
dc.contributor.authorArulananda, Surein-
dc.contributor.authorShackleton, Mark-
dc.contributor.authorMcArthur, Grant-
dc.contributor.authorÖstör, Andrew-
dc.contributor.authorCebon, Jonathan S-
dc.contributor.authorSolomon, Benjamin-
dc.contributor.authorBuchanan, Russell R C-
dc.contributor.authorWicks, Ian P-
dc.contributor.authorLo, Serigne-
dc.contributor.authorHicks, Rodney J-
dc.contributor.authorSandhu, Shahneen-
dc.identifier.citationEuropean journal of cancer (Oxford, England : 1990) 2018; 105: 88-102-
dc.description.abstractRheumatic immune-related adverse events (irAEs) occur in approximately 10-20% of anti-programmed death 1 (anti-PD1)-treated cancer patients. There are limited data on the natural history, optimal treatment and long-term oncological outcomes of patients with rheumatic irAEs. The objective of the study was to describe the spectrum and natural history of rheumatic irAEs and the potential impact of rheumatic irAEs and immunomodulators on anti-PD1 tumour efficacy. Cancer patients with pre-existing rheumatic disease before anti-PD1 therapy or de novo rheumatic irAEs on anti-PD1 therapy were retrospectively reviewed across three sites. Patient demographics, treatment history, anti-PD1 irAEs, and anti-PD1 responses were evaluated. Relationships between the development or pre-existence of rheumatic irAE, use of immunomodulatory agents and outcomes were evaluated. This multicenter case series describes 36 cancer patients who had rheumatic disease before anti-PD1 therapy (n = 12) or developed de novo rheumatic irAEs (n = 24). Thirty-four of the 36 patients sustained rheumatic irAEs (median time to rheumatic irAE: 14.5 weeks), including 24 de novo (18 inflammatory arthritis, three myositis, two polymyalgia rheumatica, one fasciitis) and 10 flares in 12 patients with pre-existing rheumatic disease. Corticosteroids were used in 30 of 36 patients (median duration: 10 months), and disease-modifying antirheumatic drugs were used in 14 of 36 patients (median duration: 5.5 months). The objective response rate to anti-PD1 therapy was 69% (n = 25/36) overall and 81% (n = 21/26) in the melanoma subgroup. Rheumatic irAEs are often chronic and require prolonged immunomodulatory therapy. Prospective studies are required to define optimal management of rheumatic irAEs that maintain long-term anticancer outcomes.-
dc.subjectAnti–programmed death 1 antibodies-
dc.subjectDisease-modifying antirheumatic drug-
dc.subjectImmune checkpoint inhibitor-
dc.subjectImmune-related adverse event-
dc.subjectPolymyalgia rheumatica-
dc.subjectRheumatic irAE-
dc.titleRheumatic immune-related adverse events secondary to anti-programmed death-1 antibodies and preliminary analysis on the impact of corticosteroids on anti-tumour response: A case series.-
dc.typeJournal Articleen
dc.identifier.journaltitleEuropean journal of cancer (Oxford, England : 1990)-
dc.identifier.affiliationWalter and Eliza Hall Institute, Melbourne, Australiaen
dc.identifier.affiliationDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australiaen
dc.identifier.affiliationAlfred Hospital, Melbourne, Australiaen
dc.identifier.affiliationDepartment of Rheumatology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Rheumatology, Royal Melbourne Hospital, Australiaen
dc.identifier.affiliationDepartment of Clinical Pharmacology and Therapeutics, Austin Health, Melbourne, Australiaen
dc.identifier.affiliationSir Peter MacCallum Department, University of Melbourne, Melbourne, Australiaen
dc.identifier.affiliationDepartment of Medicine, University of Melbourne, Australiaen
dc.identifier.affiliationOlivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationCabrini Health, Melbourne, Australiaen
dc.identifier.affiliationMelanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australiaen
dc.identifier.affiliationInstitute for Research and Medical Consultations, University of Dammam, Dammam, Saudi Arabiaen
dc.type.austinJournal Article-, Russell R C
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.openairecristype Pharmacology and Therapeutics- Oncology- Oncology- Newton-John Cancer Research Institute-
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