Uncommon but Significant: Onset, Characteristics and Management of Vasculitis and Connective Tissue Diseases Induced by Immunomodulators during Cancer Treatment

Discov Med. 2024 Dec;36(191):2333-2342. doi: 10.24976/Discov.Med.202436191.215.

Abstract

The introduction of immunomodulators as adjuvant therapies in cancer treatment has represented a significant advancement in oncology, improving therapeutic response and patient survival. Emerging targets and molecules could provide new therapeutic opportunities for cancer patients. However, these agents can induce immunological side effects, including vasculitis and connective tissue diseases, which, while uncommon, present significant clinical challenges. This review analyzes the prevalence, clinical characteristics, therapeutic strategies, and management difficulties of vasculitis and connective tissue disorders triggered by immunomodulators in the context of cancer treatment. Although rare, these conditions significantly impact patients, demanding thorough management. Common rheumatological immune-related adverse events include inflammatory arthritis, Sjogren's disease, systemic lupus erythematosus, and systemic sclerosis, all of which require prompt recognition and appropriate intervention. Treatment frequently includes corticosteroids and immunosuppressive drugs, with new alternatives currently accessible. Efficient coordination between oncologists and rheumatologists enhances patient outcomes, highlighting the necessity for organized multidisciplinary strategies. Future research initiatives emphasize the identification of biomarkers for early diagnosis and the development of preventive methods to reduce immune-related adverse events in cancer therapy.

Keywords: autoimmune diseases; cancer immunotherapy; immune checkpoint inhibitors; immune-related adverse events; immunosuppressive therapy; rheumatological complications.

Publication types

  • Review

MeSH terms

  • Connective Tissue Diseases* / drug therapy
  • Connective Tissue Diseases* / immunology
  • Connective Tissue Diseases* / therapy
  • Humans
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use
  • Immunomodulating Agents / adverse effects
  • Immunomodulating Agents / therapeutic use
  • Neoplasms* / drug therapy
  • Neoplasms* / immunology
  • Neoplasms* / therapy
  • Vasculitis* / chemically induced
  • Vasculitis* / immunology
  • Vasculitis* / therapy

Substances

  • Immunologic Factors
  • Immunomodulating Agents