Association between Changes in the Patterns of Antinuclear Autoantibodies during Immune Checkpoint Inhibition Therapy and the Development of Severe Immune Related Adverse Events
Por:
Alserawan, L, Anguera, G, Atenza, CZ, Lopez, JS, Martinez-Martinez, L, Melia, MR, Sullivan, I, Joaquin, AB, Tarruella, MM, Vidal, S
Publicada:
1 oct 2022
Resumen:
Immune-related adverse events (irAEs) are unpredictable autoimmune-like toxicities induced by immune checkpoint inhibitors (ICI). irAEs are a consequence of a breakdown in self-tolerance. ICIs can induce autoantibody formation, and the presence of antinuclear autoantibodies (ANAs) has been reported in patients who developed irAEs. Our goal was to compare ANA patterns by indirect immunofluorescence at different timepoints before (baseline) and after the initiation of ICI treatment and to analyze the role of ANA pattern changes as predictors of irAEs. This is a 2-year-follow-up prospective study of 152 consecutive patients with solid tumors treated with anti-PD-(L)1 blockade agents. They were included from September 2018 until March 2020 in the Hospital de la Santa Creu I Sant Pau (Barcelona, Spain). We grouped patients into three groups: ANA de novo (patients who showed new ANA patterns at any time after ICI initiation), ANA (ANA positive at baseline without changes in the ANA patterns after initiation of treatment) and non-ANA (ANA negative at baseline and after ICI initiation). We did not find any association between the appearance of ANAs and irAE rates or the number and types of irAEs. However, patients in the ANA de novo group showed higher severe irAE rates (grade >= 3) than the other groups. Additionally, in most of the patients with severe irAEs (83.3%), changes in ANA patterns preceded irAE onset. In conclusion, we found ANA induction during ICI therapies in 22 patients and our results suggest that the appearance of ANAs may predict the severity of the irAE.
Filiaciones:
Alserawan, L:
IIB St Pau, Immunol Inflammatory Dis, Biomed Res Inst St Pau, Barcelona 08026, Spain
Anguera, G:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona 08026, Spain
Atenza, CZ:
IIB St Pau, Immunol Inflammatory Dis, Biomed Res Inst St Pau, Barcelona 08026, Spain
Lopez, JS:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona 08026, Spain
Martinez-Martinez, L:
Hosp Santa Creu & Sant Pau, Dept Immunol, Biomed Res Inst St Pau IIB St Pau, F-08026 Barcelona, France
Melia, MR:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona 08026, Spain
Sullivan, I:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona 08026, Spain
Joaquin, AB:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona 08026, Spain
Tarruella, MM:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona 08026, Spain
Vidal, S:
IIB St Pau, Immunol Inflammatory Dis, Biomed Res Inst St Pau, Barcelona 08026, Spain
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