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Rheumatic Complications from Immune Checkpoint Inhibitors
Immune checkpoint inhibitors (ICIs), such as anti-programmed cell-death 1/programmed death-ligand 1 (anti-PD-1/PD-L1) or anti-CTL-associated protein (anti-CTLA-4), have dramatically changed the treatment of advanced cancers over the past decade. ICIs block T cell inhibition, thus increasing the anti-tumor immune response. ICIs are used not only for metastatic cancer, but also as adjuvant treatment for some stage…
The Immune Checkpoint Inhibitors Unleashed to Fight Cancer
A 53-year-old female presented to the clinic for severe polyarticular joint pain and was found to have a seronegative inflammatory arthritis. Six months before, she had completed 10 months of treatment for stage IV metastatic melanoma with the immune checkpoint inhibitors, nivolumab and ipilimumab, achieving complete remission of her cancer. She said that throughout her…
Rheumatology Case Report: Immune-Related Aortitis Associated with Ipilimumab
Ipilimumab (Yervoy) is a monoclonal antibody directed against cytotoxic T-lymphocyte antigen 4 (CTLA-4). It was the first drug to demonstrate a survival benefit in advanced melanoma and was approved by the FDA in 2011.1 By blocking the CTLA-4 receptor, ipilimumab enhances the immune response against tumors via cytotoxic T lymphocyte activation and proliferation.2 However, immunopotentiating…
Immune Checkpoint Inhibitors & Immune-Related Adverse Events
Immune checkpoint inhibitors (ICIs) are at the forefront of advances in cancer therapy and have shown promising results for progression-free survival. Checkpoint signaling pathways, such as cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1), normally regulate the immune response to promote self-tolerance and prevent tissue damage and inflammation. PD-1 is a…