title: Opportunistic autoimmunity secondary to cancer immunotherapy (OASI): An emerging challenge.
abstract: With "checkpoint inhibitors" targeting PD1/PD-1-ligands or CTLA-4/CD28 pathways, immunotherapy has profoundly modified therapeutic strategies in oncology. First approved in refractory metastatic neoplasms (melanoma and lung adenocarcinoma), it is now being tested broadly in other cancers and/or as adjuvant treatment. For a significant proportion of patients, immunotherapy is responsible for "immunological" events, identified as Immune-Related Adverse Events (irAEs). Owing to the increasing number of prescriptions, identification and management of specific immunological side effects is crucial and requires close collaboration between oncologists and internists and/or other organ specialists. Within irAEs, we propose to individualize the induced autoimmunity by the term "Opportunistic Autoimmunity Secondary to Cancer Immunotherapy" (OASI). The aims of this article are (1) to present the different available checkpoint inhibitors and the OASIs reported with these treatments and (2) to propose practical recommendations for diagnosis, pre-therapeutic assessment and management of OASIs. The need for predictive biomarkers of OASIs occurrence will also be discussed.
authors.affiliation: Département de rhumatologie, hôpital Pellegrin, place Amélie-Raba-Léon, Bordeaux, France.
authors.forename: M
authors.initials: M
authors.lastname: Kostine
authors.affiliation: Service de médecine interne, département de médecine interne et infectiologie, hôpital européen de Marseille, 6, rue Désirée-Clary, Marseille, 13003 France. Electronic address: l.chiche@hopital-europeen.fr.
authors.forename: L
authors.initials: L
authors.lastname: Chiche
authors.affiliation: Département de médecine interne, hôpital du Haut-Lévêque, Pessac, France.
authors.forename: E
authors.initials: E
authors.lastname: Lazaro
authors.affiliation: Service de médecine interne, département de médecine interne et infectiologie, hôpital européen de Marseille, 6, rue Désirée-Clary, Marseille, 13003 France.
authors.forename: P
authors.initials: P
authors.lastname: Halfon
authors.affiliation: Service de médecine interne, département de médecine interne et infectiologie, hôpital européen de Marseille, 6, rue Désirée-Clary, Marseille, 13003 France; Département de rhumatologie, hôpital Saint-Joseph, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Charpin
authors.affiliation: Département de rhumatologie, hôpital Saint-Joseph, Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Arniaud
authors.affiliation: Service de médecine interne, département de médecine interne et infectiologie, hôpital européen de Marseille, 6, rue Désirée-Clary, Marseille, 13003 France.
authors.forename: F
authors.initials: F
authors.lastname: Retornaz
authors.affiliation: Département d'immunologie, hôpital Pellegrin, Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Blanco
authors.affiliation: Département de néphrologie, hôpital de la conception, AP-HM, Marseille, France.
authors.forename: N
authors.initials: N
authors.lastname: Jourde-Chiche
authors.affiliation: Département de rhumatologie, hôpital Pellegrin, place Amélie-Raba-Léon, Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Richez
authors.affiliation: Service de médecine interne, département de médecine interne et infectiologie, hôpital européen de Marseille, 6, rue Désirée-Clary, Marseille, 13003 France.
authors.forename: C
authors.initials: C
authors.lastname: Stavris
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000276:immunology; D015551:Autoimmunity / Q000187:drug effects*; D059447:Cell Cycle Checkpoints / Q000187:drug effects; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects*; D009369:Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D004791:Enzyme Inhibitors
keywords: Autoimmunity; Cancer; Checkpoint inhibitors; Immunotherapy; Opportunistic